Triage Technology

Funny how perceptions can change. The phrase mass-casualty incident sure doesn't suggest what it used to. For most of you, since 9/11, those words no longer conjure images of a car crash involving five or six people. Mass now potentially means dozens, maybe hundreds, possibly thousands. Incident now could mean something as huge as a chemical or biological attack, a train derailment, a plane crashing into a skyscraper.

Big has gotten bigger. And when you're speaking of casualties, so has the challenge of triaging them. Whatever the difficulties of prioritizing a handful of people by life-threat and viability, they pale against the challenge of doing so for hundreds.

It is with this in mind that EMS presents the products on these pages. From some of the prehospital industry's major manufacturers, they are designed to assist providers in quickly and accurately triaging and treating what could be large numbers of patients. They're not only for large events; many are also applicable to the smaller day-to-day incidents that comprise the large bulk of what you do. Either way, though, they can help you help those in need--no matter the incident's size, scope or seriousness. Give them some consideration.

Triage Tags--The Command Post/Ferno

As part of its wide line of triage and mass-casualty supplies, Ferno offers several styles of triage and identification tags.

The Ferno Triage Tag, available from The Command Post, a Ferno company, accommodates both the RPM(respirations, perfusions, mental status) and SLUDGE (salivation, lacrimation, urination, defecation, gastrointestinal distress, emesis) triage methodologies. When users are employing the START system, it has four color-coded sections: green (Priority 3, for minor injuries/conditions), yellow (Priority 2, for delayed treatment), red (Priority 1, or needing immediate assistance) and black (Priority 0, deceased or unsalvageable).

A decon section has room for noting use of a Mark I kit or diazepam, with additional room to record time of administration, dosage, etc. As well, a tearaway transport section enables traceability once a patient is moved from the scene, and a personal-belongings tearaway facilitates tracking of effects like wallets, jewelry, clothing, etc.

The company also offers the StatBand ERT-101 all-in-one triage tag and ERT-102 pre-barcoded tag for everyday emergency response. The ERT-101 includes pre-coded patient and triage status labels, symbols and a writable surface for recording vital signs, hazmat exposures and other patient notes. The ERT-102 also features uniquely numbered barcodes and labels for easy tracking of patients and their belongings. Both ERT tags are water- and abrasion-resistant, with integrated adhesive tabs.

Ferno also offers triage tarps, ribbons, flags and other supplies, including the First Out Triage Fanny Pack. For more information, call 800/733-3766, or visit www.ferno.com.

TEMPS Bed--Emergency Preparedness Systems

In a major event, you may need additional bed capacity, stat. But in the prehospital environment, that can be a challenge. Where can you put those people?

Emergency Preparedness Systems offers a solution in its TEMPS (for Triage and Emergency Management Preparedness System) bed. Part of a system that also includes a color-coded visual indicator to provide triage information at a glance, the TEMPS bed was developed in conjunction with top trauma and emergency medical experts and has been field-tested in MCI drills in several states.

The bed itself sits atop a knockdown patient gurney made of polyvinyl chloride resin structural tubing that won't crack, dent or sustain bacterial growth. Patients are supported by a vinyl-coated polyester mesh that's tension-adjustable for maximum comfort. The whole thing assembles in less than 30 seconds and can hold up to 300 lbs. Another model carries a higher weight capacity.

What's more, five TEMPS beds can be stored in the space of one by using a mobile transport and storage cart that is easily transportable to and from triage areas.

Additional bed features include three safety belts, a design that holds an x-ray film tray, a five-position elevating backrest, a comfortable 31" working height and a narrow profile (25") that won't block hallways.

Optional features include a snap-on IV pole, an oxygen tank holder, a solid CPR backboard for cardiac procedures, a patient chart holder, a poly-backed bio-absorbent sheet for blood/body fluid containment, an isolation canopy, an all-terrain chassis and a hamper for patients' personal items. Mattress overlays are available for longer-term use.

The color-coded triage indicator comes in green, yellow, red and black, with other colors available upon request.

For more information, call 800/478-2363, e-mail info@tempsbed.com or visit www.tempsbed.com.

EMSware Software--Disaster Management Solutions

Triage isn't just a matter of assessing your patients' conditions and ordering them for treatment. It also involves drug stockpiles that have to be controlled, volunteers who need guidance and a continuum of medical care in which you're only one part. To keep a handle on all these things, Disaster Management Solutions (DMS) offers the EMSware suite of integrated software solutions.

EMSware allows the efficient tracking of patient counts, statuses and locations, the verification that prescribed medications were administered, and additional query capabilities for age, gender, location, etc. It also facilitates lot traceability and keeping track of drug inventory counts, and provides real-time quantity updates. In managing volunteers, it enables the maintenance of staff profiles (medical histories, etc.) and the tracking of time and expenses for potential reimbursement.

Data is collected at the source using portable data terminals. Barcodes and pick lists simplify data entry, enhancing accuracy over transcription by hand. Data collected with the portable terminals can be stored internally and uploaded when the devices are docked (batch mode), or transmitted wirelessly (802.11b protocol) to an EMSware-equipped PC as it's collected. The wireless terminals can switch to batch mode should connectivity to the host be lost or unavailable.

EMSware is customizable and upgradeable, meaning that users can change their data definitions within the application. New features can be added by regenerating the application with the upgraded engine.

Developed without proprietary languages or tools (it uses Microsoft's well-known VB language), EMSware can operate on Access, SQL Server, Oracle or DB2 databases, and runs on most pocket PC devices.

For more information, call 909/594-9596, or visit www.disastermanagementsolutions.com.

Smart Incident Command System--TSG?Associates

If another New York institution is ever hit by terrorists, EMS providers there will have a new system for identifying and prioritizing the injured.

The state of New York has utilized federal grant funds to outfit EMS personnel throughout the state with the Smart Incident Command System from TSG?Associates. The system, already in use in the United Kingdom by emergency services and the British military, has also been adopted in parts of Texas.

The Smart Incident Command System is a multiple-casualty incident management system that assists providers in ranking victims by their degrees of urgency. It features specific protocols and high-visibility tags for displaying a victim's grouping.

Central to the system is the Smart Tag, which providers use to group patients by color code. The tag features a folded design that allows multiple classifications, depending on which side is displayed, and contains space for a permanent record of treatments provided and patient details. The Smart Tag will withstand all weather conditions and even decontamination processes.

"Producing the maximum number of survivors from any multi-casualty incident," says TSG director Colin Smart, "is what our system is all about."

TSG is based in the U.K., but is represented in America by Bound Tree Medical It has distributors in Arizona, New Hampshire, Ohio and Utah.

For more information, visit www.tsgassociates.co.uk, or e-mail info@boundtree.com.

Trailer Packages--FSI North America

Say it's something big--a chemical release at a school, for instance. What do you do with several hundred victims?

FSI North America, a division of Fire Safety International, offers fully configured trailer systems for treating mass-casualty/trauma victims and those requiring decontamination. The largest in its line, a 28-footer (Model #F-THDP28) can accommodate up to 500 ambulatory patients, 650 trauma patients or 1,000 receiving decon; this lists for $224,999. For smaller budgets, the 20-foot version (#F-THDP20) can handle 400 ambulatory patients, 500 trauma patients or 400 receiving decon.

Other models range from 24 feet (the #F-TDHP24 WMD Trailer) down to 6 feet (the F-THDP6 Hazmat Decon Trailer System). With an eye on "one-stop shopping," FSI offers each of them fully outfitted with necessities like backboards, triage and EMS supplies, bandages, splints, IV fluids, rapid-response kits, flag kits, shelters, decon showers and more.

For more information, call 440/891-1523, or visit www.fsinorth.com.