Emergency Preparedness and Bioterrorism: Triage, Agents, and Response
A 42-year-old male arrives at the Emergency Department (ED) self-transported after a reported explosion and release of white powder at a local transit hub. He reports sudden onset of high fever, malaise, and a non-productive cough. Vital signs: Temp 103.1°F (39.5°C), HR 112 bpm, RR 28/min, BP 102/64 mmHg, SpO2 90% on room air. The client appears tachypneic and is using accessory muscles to breathe. He states, 'Everything happened so fast; I just saw the cloud and started coughing.' The skin is warm and diaphoretic with no visible trauma noted.
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Disaster Triage and START Method
In a mass casualty incident (MCI), the goal is to do the greatest good for the greatest number of people. The Simple Triage and Rapid Treatment (START) method categorizes patients based on respiration, perfusion, and mental status (RPM).
- Red (Immediate): Life-threatening injuries but treatable (e.g., airway obstruction, tension pneumothorax).
- Yellow (Delayed): Serious but not immediately life-threatening (e.g., stable fractures).
- Green (Minor): 'Walking wounded' with minimal injuries.
- Black (Expectant): Dead or unlikely to survive despite intervention.