|Health Services Organization in the Event of Disaster (PAHO, 1989, 129 pages)|
|Chapter 3: Organization of medical care units in the disaster area|
|Triage and tagging of casualties|
Ideally, a physician should be taken in the ambulance to the scene of the accident to take charge of the triage area where all casualties, regardless of the extent of injury, will be processed. The doctor at the triage area will also assist in matters having to do with documentation and communication - important aspects of disaster management which are very difficult to set up in the first hours after the accident.
The first task is to determine the magnitude of the disaster. This may be done with the help of a police officer who happens to be available. In addition, liaison should be established with the hospitals that will receive the victims and with the ambulances, civil defense authorities, police, firefighters, Red Cross, Army, Navy, Air Force, and other agencies providing emergency aid.
The next step is to identify those patients who require immediate attention and dispatch them promptly to the hospital.
Treatment at the scene of the accident should be limited to basic resuscitation procedures needed to save lives. If a number of patients require these measures or are trapped and seriously injured, the medical triage officer at the scene of the accident will request the assistance of a mobile medical unit.
When the number of wounded is critical and resources are inadequate, an unusual procedure assumes vital importance: a distinction must be made between those who may respond to treatment and those who are bound to die. An adequate ambulance team should be reserved for the latter.
All deaths should be certified, so as to avoid losing time by using medical personnel to confirm them.