Aka Triage – Are you hurt?

By Paul MacMillan, AEMT

Cover photo courtesy Dundar Sahin and AKUT

I have been asked to write an article on triage and Mass Casualty Incidents (MCI). You might ask why are we writing an article on triage and MCI? Given the world we now live in, it is a good time to review these topics. With mass casualty incidents happening more frequently in schools, malls, political gatherings, and on mass transit systems it is important to know how to respond to save lives. Often when we teach these topics it is at the end of the course and we quickly cover them because of time constraints.

There is a wealth of data on these topics. You might recall one of the most famous studies. It focused on the Avianca, Flight 52, plane crash in Cove Neck, New York. It happened on a foggy and windy night on January 25, 1990. A number of volunteer fire and rescue units responded to this incident where 8 out of the 9 crew members of the aircraft were killed and 65 out of 149 passengers were killed. You may recall that during this event there was a huge problem with all the responders’ vehicles and equipment parked on either side of a narrow road which made it impossible for ambulances to get to the scene or turn around. This incident has changed how we now stage resources at MCIs.

Unfortunately, we have a wealth of data on triage and evacuation coming from the Iraqi and Afghanistan war. For example the battlefield injury survival rate for U.S. military personnel in Iraq reached 90%. This was 10 points higher than what was seen in the 1991 Persian Gulf War. Maj. Gen. George W. Weightman, commander of the Army Medical Department’s Center and School at Fort Sam Houston in San Antonio, Texas, cited a number of things that have changed in treating battlefield injuries which have improved survival. These include improved trauma care moments after the injury and a large number of soldiers trained as combat lifesavers.

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Eyewitness Haiti—Part II

March/April 2010 ISSN1059-6518  Volume 23 Number 2

Eyewitness Haiti—Part II

In our last issue, Dr. Frank Hubbell shared his own experience working in Haiti to provide care and treatment for  the survivors of that country’s devastating earthquake. Continuing the trend, we received the following letter from Jonathan Eisenberg summarizing his own experience volunteering as a relief worker in Haiti. Jon went to Haiti with Rowan Lewis, as a member of SOLO’s first International Relief Team to Haiti. They went to work with Housing Works clinics in Haiti and were able to lend a hand at the Miami Field Hospital during their “down” time.   We share it here just as he sent it to us. Each and every experience SOLO providers have had in Haiti has been unique and rewarding.  SOLO is dedicated to continuing to provide assistance to the people of that island.  We are thankful to all of our volunteers who have made the trip at their own expense and given so much of their time and expertise to help.  This willingness to serve is what makes SOLO instructors and students so very special.

The editors.

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Eyewitness Haiti

January/February 2010  ISBN-1059-6518  Volume 23 Number 1


Port au-Prince, Haiti

Frank Hubbell D.O.

Travel Log: February 13-20, 2010




On Tuesday January 12, 2010, at 4:53pm a 7.0 earthquake struck the capital city of Port-au-Prince, Haiti. The epicenter was located in the town of Leogane, 16miles west of Port-au-Prince. The earthquake essentially leveled Port-au-Prince (PaP) and surrounding areas, killing at least 270,000 people, and leaving approximately 3 million survivors to live on the streets and try to eke out an existence amid the piles of debris.  Three of us from Saco River Medical Group, representing several NGO’s, decided to go to PaP on a fact-finding mission and help in whatever way we could, which may mean providing assistance in non-medical areas.  Our primary contact is a Haitian physician named Jude whose clinic has been destroyed.  Saco Docs has strong ties with Jude, and we hope that the medical supplies and survival gear we are carrying will help Jude and his family get back on their feet.   As these are journal entries, often written at the end of long, hard days, by the light of a head lamp, they may not be as grammatically correct as regular articles.   Our trip is just one of thousands with similar stories.

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