The BLAST Approach: Rethinking the Way We Approach MCI Triage

  I’ve studied and taught mass casualty incident (MCI) care and response for 40 years and have found that students often get confused when tasked with memorizing rarely used triage processes or algorithms. They easily grasp and master the difference between BLS and ALS, because they use these concepts daily. However, they often stumble when at the scene of a mass casualtyor active shooter incident, where they’re tasked with rapidly determining the category of seriously or mortally wounded patients. When I train students, I explain how to perform triage as a simple modification of the daily BLS/ALS decision-making process. I show them how to integrate these modifications with the simple triage and rapid treatment (START) approach to triage, the most commonly used triage system, which was developed in 1983 by staff of Hoag Hospital and from the Newport Beach (Calif.) Fire Department.1,2 The large number of variations in systems and tags further complicates a simple process, and may inadvertently add time to patient processing time. Photo Ryan Kelley Teaching START Triage START is a simple adaptation of the daily clinical assessment of patients and uses just a few key assessment categories. When I explain each category to students, I break it down and show each priority area and its individual components. Students understand and accept it.
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Major Incidents Trauma Columns Mass Casualty Incidents Patient Care Source Type: news