[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:01.00,0:00:04.00,Default,,0000,0000,0000,,(English captions by Trisha Paul, University of Michigan.)
Dialogue: 0,0:00:05.00,0:00:11.00,Default,,0000,0000,0000,,In this session, we shall talk about mass\Ncasualty incidents.
Dialogue: 0,0:00:11.00,0:00:19.00,Default,,0000,0000,0000,,A mass casualty incident is any incident where\Nthe number of injured overwhelm the capabilities
Dialogue: 0,0:00:19.00,0:00:22.00,Default,,0000,0000,0000,,of the first arriving units.
Dialogue: 0,0:00:22.00,0:00:29.00,Default,,0000,0000,0000,,They usually involve trauma but could be acute\Nradiation, biological weapons, or poisoning
Dialogue: 0,0:00:29.00,0:00:29.00,Default,,0000,0000,0000,,from alcohol.
Dialogue: 0,0:00:29.00,0:00:35.00,Default,,0000,0000,0000,,It could be bomb blasts, it could be transportation\Ncrashes.
Dialogue: 0,0:00:35.00,0:00:45.00,Default,,0000,0000,0000,,They involve road traffic injuries, collapsed\Nbuildings, which are occurring every day.
Dialogue: 0,0:00:45.00,0:00:51.00,Default,,0000,0000,0000,,Three things are particularly important in\Nlessening injuries and deaths in mass casualty
Dialogue: 0,0:00:51.00,0:00:53.00,Default,,0000,0000,0000,,incidents.
Dialogue: 0,0:00:53.00,0:00:56.00,Default,,0000,0000,0000,,One is immediate search and rapid triage.
Dialogue: 0,0:00:56.00,0:01:00.00,Default,,0000,0000,0000,,Two, immediate first aid treatment.
Dialogue: 0,0:01:00.00,0:01:10.00,Default,,0000,0000,0000,,And three, transport to the nearest medical\Ncentre.
Dialogue: 0,0:01:10.00,0:01:16.00,Default,,0000,0000,0000,,Read the story on the bus collision.
Dialogue: 0,0:01:16.00,0:01:21.00,Default,,0000,0000,0000,,What things went wrong in that scenario?
Dialogue: 0,0:01:21.00,0:01:30.00,Default,,0000,0000,0000,,After the incident, it is important to be\Ncomposed; search and rescue should be done
Dialogue: 0,0:01:30.00,0:01:31.00,Default,,0000,0000,0000,,methodically.
Dialogue: 0,0:01:31.00,0:01:39.00,Default,,0000,0000,0000,,Stop, look, listen, and think, and call for\Nhelp!
Dialogue: 0,0:01:39.00,0:01:41.00,Default,,0000,0000,0000,,Choose a team leader.
Dialogue: 0,0:01:41.00,0:01:50.00,Default,,0000,0000,0000,,Usually security personnel are needed to secure\Nthe incident site, Zone 1 or Ground Zero as
Dialogue: 0,0:01:50.00,0:01:53.00,Default,,0000,0000,0000,,it is called in court.
Dialogue: 0,0:01:53.00,0:01:58.00,Default,,0000,0000,0000,,Wear protective gadgets including gloves and\Nhelmet.
Dialogue: 0,0:01:58.00,0:02:08.00,Default,,0000,0000,0000,,Select a medical incident commander to manage\Ntriage, treatment and transport, the 3Ts.
Dialogue: 0,0:02:08.00,0:02:11.00,Default,,0000,0000,0000,,These are very important in mass casualty\Nincidents.
Dialogue: 0,0:02:11.00,0:02:19.00,Default,,0000,0000,0000,,Triage, treatment, and transport the patient.
Dialogue: 0,0:02:19.00,0:02:25.00,Default,,0000,0000,0000,,Some ambulances are able to sustain lives\Nthat require advanced support.
Dialogue: 0,0:02:25.00,0:02:28.00,Default,,0000,0000,0000,,Call for an ambulance.
Dialogue: 0,0:02:28.00,0:02:35.00,Default,,0000,0000,0000,,Triage is a French term meaning pick and sort,\Nor select and categorize.
Dialogue: 0,0:02:35.00,0:02:39.00,Default,,0000,0000,0000,,It involves: classifying victims in order\Nto assign priorities for medical care and
Dialogue: 0,0:02:39.00,0:02:48.00,Default,,0000,0000,0000,,transportation, urgency of the case handling\Nto increase victims' likelihood of survival.
Dialogue: 0,0:02:48.00,0:02:58.00,Default,,0000,0000,0000,,The aim is to provide the greatest good for\Nthe greatest number of people injured.
Dialogue: 0,0:02:58.00,0:03:00.00,Default,,0000,0000,0000,,Triage categories.
Dialogue: 0,0:03:00.00,0:03:06.00,Default,,0000,0000,0000,,Triage uses agreed colors to communicate amongst\Npersonnel.
Dialogue: 0,0:03:06.00,0:03:13.00,Default,,0000,0000,0000,,Triage ribbons or cards can be used, although\Nin resource constrained countries, you may use
Dialogue: 0,0:03:13.00,0:03:15.00,Default,,0000,0000,0000,,other coding systems.
Dialogue: 0,0:03:15.00,0:03:23.00,Default,,0000,0000,0000,,It tells intervention teams the priority level\Nwith which to handle each affected person.
Dialogue: 0,0:03:23.00,0:03:30.00,Default,,0000,0000,0000,,This is an example of a color coded triage\Ncard.
Dialogue: 0,0:03:30.00,0:03:38.00,Default,,0000,0000,0000,,Triage categories include those injured or\Naffected persons that need immediate care,
Dialogue: 0,0:03:38.00,0:03:44.00,Default,,0000,0000,0000,,those that need delayed care, those that need\Nminor care, and those that can be classified
Dialogue: 0,0:03:44.00,0:03:47.00,Default,,0000,0000,0000,,as deceased.
Dialogue: 0,0:03:47.00,0:03:54.00,Default,,0000,0000,0000,,The Red Coded are first priority at the mass\Ncasualty incident.
Dialogue: 0,0:03:54.00,0:03:58.00,Default,,0000,0000,0000,,Immediate care should be started.
Dialogue: 0,0:03:58.00,0:04:06.00,Default,,0000,0000,0000,,They have a compromised airway, or are in\Nshock, and need immediate resuscitation.
Dialogue: 0,0:04:06.00,0:04:10.00,Default,,0000,0000,0000,,The Yellow Coded are the second priority.
Dialogue: 0,0:04:10.00,0:04:11.00,Default,,0000,0000,0000,,Urgent care is needed.
Dialogue: 0,0:04:11.00,0:04:16.00,Default,,0000,0000,0000,,They can deteriorate to Red category in a\Nshort time.
Dialogue: 0,0:04:16.00,0:04:21.00,Default,,0000,0000,0000,,They are in impending shock.
Dialogue: 0,0:04:21.00,0:04:28.00,Default,,0000,0000,0000,,The Green Coded are the third category and\Ninclude all walking wounded.
Dialogue: 0,0:04:28.00,0:04:30.00,Default,,0000,0000,0000,,Care can come later.
Dialogue: 0,0:04:30.00,0:04:35.00,Default,,0000,0000,0000,,However, they need monitoring for any sign\Nof deterioration.
Dialogue: 0,0:04:35.00,0:04:40.00,Default,,0000,0000,0000,,The Black Coded are either dead or hopelessly\Nwounded.
Dialogue: 0,0:04:40.00,0:04:43.00,Default,,0000,0000,0000,,They should not take priority time and resources.
Dialogue: 0,0:04:43.00,0:04:47.00,Default,,0000,0000,0000,,Concentrate on those that can be saved.
Dialogue: 0,0:04:47.00,0:04:49.00,Default,,0000,0000,0000,,How To Triage.
Dialogue: 0,0:04:49.00,0:04:58.00,Default,,0000,0000,0000,,Begin by assessing all non-moving patients\Nwhere they lie.
Dialogue: 0,0:04:58.00,0:05:00.00,Default,,0000,0000,0000,,Use START Triage.
Dialogue: 0,0:05:00.00,0:05:09.00,Default,,0000,0000,0000,,START, meaning Simple Triage And Rapid Treatment,\Nwhere treatment here refers to first aid treatment
Dialogue: 0,0:05:09.00,0:05:12.00,Default,,0000,0000,0000,,and follow up treatment.
Dialogue: 0,0:05:12.00,0:05:17.00,Default,,0000,0000,0000,,Triage can be performed by any individual\Nincluding non-health workers.
Dialogue: 0,0:05:17.00,0:05:23.00,Default,,0000,0000,0000,,Because of the scarcity of manpower, all who\Ncan should participate in triage.
Dialogue: 0,0:05:23.00,0:05:33.00,Default,,0000,0000,0000,,Triage Techniques: We consider three main\Naspects: respiration, blood circulation, and
Dialogue: 0,0:05:33.00,0:05:34.00,Default,,0000,0000,0000,,consciousness.
Dialogue: 0,0:05:34.00,0:05:38.00,Default,,0000,0000,0000,,Under respiration, we check: Are they breathing?
Dialogue: 0,0:05:38.00,0:05:41.00,Default,,0000,0000,0000,,And if they are breathing, what are their\Nbreaths per minute?
Dialogue: 0,0:05:41.00,0:05:48.00,Default,,0000,0000,0000,,These are important criteria that can help\Nus decide whether someone needs immediate
Dialogue: 0,0:05:48.00,0:05:51.00,Default,,0000,0000,0000,,care or delayed care.
Dialogue: 0,0:05:51.00,0:05:54.00,Default,,0000,0000,0000,,Under Blood Circulation, we check: Is there\Na pulse?
Dialogue: 0,0:05:54.00,0:06:04.00,Default,,0000,0000,0000,,If there is a pulse or if there is no pulse,\Nhow is the perfusion of blood into the tissues?
Dialogue: 0,0:06:04.00,0:06:05.00,Default,,0000,0000,0000,,Three, Consciousness.
Dialogue: 0,0:06:05.00,0:06:07.00,Default,,0000,0000,0000,,Are they conscious?
Dialogue: 0,0:06:07.00,0:06:09.00,Default,,0000,0000,0000,,Or, what is their Mental status?
Dialogue: 0,0:06:09.00,0:06:21.00,Default,,0000,0000,0000,,All these 3 areas of assessment should take\Nless than one minute per patient.
Dialogue: 0,0:06:21.00,0:06:23.00,Default,,0000,0000,0000,,Checking for Respiration.
Dialogue: 0,0:06:23.00,0:06:30.00,Default,,0000,0000,0000,,If there is no respiration or they are not\Nbreathing, open the airway and clear the airway
Dialogue: 0,0:06:30.00,0:06:37.00,Default,,0000,0000,0000,,by stretching the neck and clearing anything\Nthat may be in their mouth.
Dialogue: 0,0:06:37.00,0:06:41.00,Default,,0000,0000,0000,,If there is still none, label as black.
Dialogue: 0,0:06:41.00,0:06:45.00,Default,,0000,0000,0000,,If the respiration is restored, label as red.
Dialogue: 0,0:06:45.00,0:06:52.00,Default,,0000,0000,0000,,If the respiration rate was initially present\Nand the breathing rate was above 30 beats
Dialogue: 0,0:06:52.00,0:06:59.00,Default,,0000,0000,0000,,per minute or a visibly faster rate, label\Nas red.
Dialogue: 0,0:06:59.00,0:07:06.00,Default,,0000,0000,0000,,However, if the breathing rate is below 30\Nin the initial breathing, then go to the next
Dialogue: 0,0:07:06.00,0:07:14.00,Default,,0000,0000,0000,,stage of assessment and that is the circulation,\Nor the perfusion.
Dialogue: 0,0:07:14.00,0:07:21.00,Default,,0000,0000,0000,,Blood circulation is the same as perfusion.
Dialogue: 0,0:07:21.00,0:07:28.00,Default,,0000,0000,0000,,Check if the radial pulse is present, and\Nif it is not present, or the capillary refill
Dialogue: 0,0:07:28.00,0:07:34.00,Default,,0000,0000,0000,,is greater than 2 seconds, label as RED.
Dialogue: 0,0:07:34.00,0:07:42.00,Default,,0000,0000,0000,,If the radial pulse is present and normal\Nor the capillary refill is less than or equal
Dialogue: 0,0:07:42.00,0:07:46.00,Default,,0000,0000,0000,,to 2 seconds, then that means that circulation\Nis ok.
Dialogue: 0,0:07:46.00,0:07:53.00,Default,,0000,0000,0000,,For some patients, if they have passed the\Nrespiration test and they have also passed
Dialogue: 0,0:07:53.00,0:08:01.00,Default,,0000,0000,0000,,the circulation test, we need to check the\Nmental status.
Dialogue: 0,0:08:01.00,0:08:14.00,Default,,0000,0000,0000,,If the mental status cannot follow simple\Ncommands, then they are unconscious or have
Dialogue: 0,0:08:14.00,0:08:17.00,Default,,0000,0000,0000,,an altered level of consciousness.
Dialogue: 0,0:08:17.00,0:08:19.00,Default,,0000,0000,0000,,These are labeled as Red.
Dialogue: 0,0:08:19.00,0:08:26.00,Default,,0000,0000,0000,,If they can follow simple commands on their\Nfirst or previous test, that is respiration,
Dialogue: 0,0:08:26.00,0:08:38.00,Default,,0000,0000,0000,,circulation, then label as Yellow if they\Nare unable to walk or Green if they are walking.
Dialogue: 0,0:08:38.00,0:08:42.00,Default,,0000,0000,0000,,This is the summary algorithm.
Dialogue: 0,0:08:42.00,0:08:55.00,Default,,0000,0000,0000,,Take time to look at it.
Dialogue: 0,0:08:55.00,0:08:56.00,Default,,0000,0000,0000,,Summary.
Dialogue: 0,0:08:56.00,0:09:02.00,Default,,0000,0000,0000,,Triage is the single most important decision\Ninvolving management of mass casualty incidences.
Dialogue: 0,0:09:02.00,0:09:13.00,Default,,0000,0000,0000,,Triage evaluation involves airway and breathing,\Nthat is, respiration, checking the circulation,
Dialogue: 0,0:09:13.00,0:09:16.00,Default,,0000,0000,0000,,and checking the mental status.
Dialogue: 0,0:09:16.00,0:09:25.00,Default,,0000,0000,0000,,However, after the Triage, the Triage teams need to\Nhand over the serious cases to the first aid
Dialogue: 0,0:09:25.00,0:09:35.00,Default,,0000,0000,0000,,treatment teams. Later on, we shall look,\Nin another session, we shall look at first
Dialogue: 0,0:09:35.00,0:09:41.00,Default,,0000,0000,0000,,aid treatment. Medical facilities are encouraged\Nto develop mass casualty plans for their facilities
Dialogue: 0,0:09:41.00,0:09:47.00,Default,,0000,0000,0000,,based on operating capacity and resources.\NDistrict committees and local authorities
Dialogue: 0,0:09:47.00,0:09:53.00,Default,,0000,0000,0000,,should identify key players in search and\Nrescue and in first aid.
Dialogue: 0,0:09:53.00,0:09:57.00,Default,,0000,0000,0000,,Thanks for listening.