Practical Exercise

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Pediatric Disaster Life Support

• Practical Exercise
• Andrew L. Garrett, MD
• Richard V. Aghababian, MD

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Purpose

• One of the goals of PDLS is to provide you with
  tools to better take care of children during a
  disaster
• Triage is not a difficult process technically,
  but the stress of performing triage in the field
  can not be done in the classroom

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Scenario

• As we are teaching this segment, a moderate
  earthquake strikes this region

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Scenario

• During the shaking, a schoolbus full of children
  and some adults swerves off of the road, down an
  embankment, and comes to rest in a parking lot.
  It has rolled over at least once.

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Request for Volunteers

• You are asked to join a quickly formed medical
  team to assist down the street
• There is a hospital with a small emergency room
  just down the street
• You have access to one ambulance, which can carry
  two patients

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Accident Scene

• There were reportedly 16 students and one driver
• Many of the students are off of the bus
• There was a fire after the crash
• Fire and EMS personnel are removing patients

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Your Mission

• Triage the patients that are being deposited in
  the parking lot by fire department and EMS
  personnel
• Categorize them as RED, YELLOW, GREEN, or BLACK
• When you are done, tell the Loading Officer the
  order to transport to the hospital or place them
  at a treatment area at the school

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Patients on Scene
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Time

• Identifying the sickest patients needs to be done
  quickly
• Triage should take less than 15-30 seconds per
  patient
• Slower while you are learning
• Keep moving as much as possible

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No. 12
Each patient will have a number and a description
of their injuries and vital signs
AGE 10 years INJURIES head injury MENTAL
STATUS awake AMBULATORY no RESP. RATE
28 PALPABLE PULSES yes
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Make a List

• In a disaster you will probably not have
  preprinted forms
• Use a number or a triage tag to identify each
  patient
• Make a list for the Loading Officer
• Number on Patient
• Triage Category (color)
• Disposition (load them now, hold them on site for
  the time being)

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Triage Identification

• Colored tape or tags can be used, or a simple
  list can be made

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Group Patients by Color
A colored cloth, or a flag, or sign can help
identify treatment areas on scene