accidentes mayores
DESCRIPTION
Accidentes en aviaciónTRANSCRIPT
MAJOR INCIDENTSMAJOR INCIDENTS
Wg Cdr David Bruce MBE MSc MBBS FIMC RCS(Ed) MRCGP AFOM DAvMed MRAeS
AKC
Wg Cdr David Bruce MBE MSc MBBS FIMC RCS(Ed) MRCGP AFOM DAvMed MRAeS
AKC
Ecuador Jun 04Ecuador Jun 04
MAJOR INCIDENTSMAJOR INCIDENTS
Definition of Major Incidents
RelevanceManagementTriage
Definition of Major Incidents
RelevanceManagementTriage
Ecuador Jun 04Ecuador Jun 04
MAJOR INCIDENTSMAJOR INCIDENTS
Your aim at any major incident should be to produce the largest number of survivors
Your aim at any major incident should be to produce the largest number of survivors
MAJOR INCIDENTSMAJOR INCIDENTS
Any incident where the number, severity or type of live casualties, or its location, requires extraordinary resources
Any incident where the number, severity or type of live casualties, or its location, requires extraordinary resources
Major IncidentsMajor Incidents
Simple
Compound
Natural
or ……..
Simple
Compound
Natural
or ……..
Man-made
Compensated
Uncompensated
Most are man-made, simple and compensated in Europe
Man-made
Compensated
Uncompensated
Most are man-made, simple and compensated in Europe
Scenes similar to this are routine events in emergency service work.
Effective scene management allows for;
• inter-service command
• safe working practices
• comprehensive scene assessments
• effective communications
• triage
• appropriate treatment
• transportation to definitive care.
Scenes similar to this are routine events in emergency service work.
Effective scene management allows for;
• inter-service command
• safe working practices
• comprehensive scene assessments
• effective communications
• triage
• appropriate treatment
• transportation to definitive care.
Routine IncidentsRoutine Incidents
TRIAGE SORTTRIAGE SORTM - Major Incident declared
E - Exact location
T - Type of incident
H - Hazards present and potential
A - Access to scene
N - Number and type of Casualties
E - Emergency services on scene
M - Major Incident declared
E - Exact location
T - Type of incident
H - Hazards present and potential
A - Access to scene
N - Number and type of Casualties
E - Emergency services on scene
Major IncidentMajor Incident
CCommand - Comando SSafety - Seguridad CCommunications - Comunicaciones AAssessment- Evaluación TTriage - Clasificación TTreatment -Tratamiento TTransport - Transporte
CCommand - Comando SSafety - Seguridad CCommunications - Comunicaciones AAssessment- Evaluación TTriage - Clasificación TTreatment -Tratamiento TTransport - Transporte
MANAGEMENTMANAGEMENT
Command, control and safetyCommand, control and safety
Command and ControlCommand and Control
Gold – strategic control, often remote
Silver – tactical, on scene comms / incident control room
Bronze – operational, functional commanders on scene and may be multiple
Gold – strategic control, often remote
Silver – tactical, on scene comms / incident control room
Bronze – operational, functional commanders on scene and may be multiple
CommunicationsCommunications
T4
T1
T2
T3
ICP
T4
T1
T2
T3
ICPTemp MortuarySRC
Casualty Clearing StationCasualty Clearing Station
T4
T1
T2
T3
ALPALPALPALP Triage Triage PointPointTriage Triage PointPoint
Body Holding Area
Equipment Store
TriageTriage
Trier ‘to sort’ Used when casualties outnumber skilled
rescuers Recognises that you will not be able to save
everyone Repeated learning in conflict
Trier ‘to sort’ Used when casualties outnumber skilled
rescuers Recognises that you will not be able to save
everyone Repeated learning in conflict
Gradings
ArmyRAF/
NATOCivilian Colour Plain
P1 T1 Immediate
P2 T2 Urgent
P3 T3 Delayed
T4 Expectant
Triage SieveT3
Delayed
T2Urgent
T1Immediate
Dead
Walking wounded?
Breathing? Open airway
Breathing rate <10 or > 30?
Pulse rate > 120
Breathing?
No
No
Yes
No
No
No
Yes
Yes
Yes
Yes
SMART Triage System
CRUCIFORM Triage System
Other Triage Systems
• Metag
• Locally produced systems
• Coloured pegs
• Balloons
TRIAGE SORTTRIAGE SORT
Triage Sort
Triage Sort
• Uses Triage Revised Trauma Score
• TRTS scores match Triage gradings
Resp Rate Systolic BP mmHg
GCS
10-29 4 >90 4 13-15 4
>29 3 76-89 3 9-12 3
6-9 2 50-75 2 6-8 2
1-5 1 1-49 1 4-5 1
0 0 Nil 0 3 0
TRTS
• TRTS 1-10 = T1
• TRTS 11 = T2
• TRTS 12 = T3
• TRTS 0 = Dead
• Survival Rates• TRTS 12 = 99.5 %• TRTS 11 = 97%• TRTS 10 = 88%• TRTS 8 = 66.5%• TRTS 6 = 63%• TRTS 4 = 33%• TRTS 1 = 25%
ANY QUESTIONSANY QUESTIONS
????