Smart Systems for Casualty Management

The aim in any multiple casualty incident should be to produce the largest number of survivors. Some patients will die and others will live, irrespective of the treatment they receive. However, for many, staying alive is totally dependent on getting immediate medical treatment. How efficiently this group can be identified will have a significant impact on overall survival rates.

The process
Triage, a word evolved from the French 'trier', to sort, is a process of categorisation needed whenever the number of casualties exceeds the number of medics or rescuers. Triage does not require advanced diagnostic skills. What it does need is a system for accurate and rapid patient assessment to identify those who can walk to safety, those who can wait for treatment and those who simply cannot. The START system (Simple Triage and Rapid Transport) is widely recognised. It colour codes patients according to their physical responses; red for the critically injured who require immediate intervention, yellow for patients who are immobile but will not die if treatment is delayed, green for walking wounded and black for patients who are either dead or expectant, with injuries they are not expected to survive.

The principle is well understood by rescue professionals, but how efficient the process is in practice depends on a number of factors, not just the skills of the triage officer but also the systems and equipment used for triage and incident management.

The products
In evaluating the whole area of triage and trauma, our colleagues at medekit.com have introduced the full range of Smart Incident Management and Triage systems to their catalogue, unique products which have achieved proven results in the quality of the triage process and are now being adopted all over the world. The products dovetail to provide a complete integrated triage management solution, but can also be used individually to enhance existing systems.

For medics on the frontline, Smart Tag is an innovative triage identification system that expands on the START coding to include a blue tag for expectant patients and a black tag only for those confirmed as dead. What is unique about Smart Tag® is that it allows a dynamic approach to the whole process, which means a first diagnosis can subsequently be altered.

Explains General Manager at medekit, Lorna Powell, "The Smart Tag is the only system we have found that properly reflects the changing nature of any mass casualty incident, the fact that patients may deteriorate, or in fact improve as more resources arrive on the scene."

Other key features include the ability to use the Smart Tag® to log any treatment and who it was administered by, creating a permanent record of activity which then stays with the patient at all times. Removable transport strips that can be taken from casualties as they leave the scene provide a valuable central record of casualty priority, evacuation method and hospital destination.

The people
Smart Tags are the innovation of TSG Associates, a company founded by former systems specialists and rescue professionals with a prime objective of assisting in rapid and effective triage and ultimately saving the maximum number of lives.

Fabricated from a tough, waterproof material, Smart Tag retains its integrity even if transportation to a treatment room or hospital is delayed. It will survive a decontamination shower and can even be written on underwater. Smart Tag is packaged in a durable belt pouch that leaves rescuers with their hands free to assess and treat casualties.

Director Colin Smart, himself a former rescue medic, explains, "Smart Incident Command System has been designed by rescue professionals for rescue professionals. It is a fully integrated solution, innovative equipment and training which have had a positive impact on all types of disaster and emergency."

The management
Part of this solution is a pack for onsite incident management. Smart Commander, a mobile incident control centre with detachable incident control boards, is exactly what is needed to move an incident response plan out from behind a desk and into the field. Arriving on scene with Smart Commander, the Incident Commander has all the tools for an efficient and structured management response, the means to record developments and gather information to achieve informed decision-making. Each unit contains two Smart dispatchers for logging casualty movement and three A3 internal information holders.

The combination of careful attention to systems management and practical application has proved a powerful combination in the field. Commenting on its efficacy, Dr Judith Fisher, a founder member of the World Association of Disaster and Emergency Medicine confirms, "I have been medical incident officer at many multiple casualty incidents including terrorist bombing and highjackings. The Smart Incident Command System is by far the most practical, well thought out and ultimately relevant range of equipment I have seen."

The full range of products in the Smart Incident Command System are now available through medekit.com.

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