Just cant find the facts.

Ms.Medic

Ms.Medic

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In a mci you have 3 "red" pts, 10 "green" pts, four "black" pts, and 3 "yellow" pts. You have initiated treatment of a "red" who suddenly goes into cardiac arrest ? What do you do ? Put them in the "black pile", or continue treatment as you immediately transport ? Does anyone have a "hard core" solid right answer ? I got this wrong on one of my test questions, went back to find the right answer, and so far what I've looked at has different answers.
 
If the red went into arrest and there are still other patients who need to be attended to, then black tag it would be my 'by the book' answer. Truthfully, though, I can see an argument that a provider should give it one go with an AED or manual defib.
 
I'd at least do one round of CPR and drugs, so long as no one else is going critical. Depending on the situation, though. Are there more people getting hurt? Are you surrounded by fire? Are the air raid sirens going off and advising you to run to the bomb shelters?

It all depends, I guess.
 
As said above, there's a book answer and a reality answer.

Book answer is they're now black, but in reality you have to look at it. For instance what happened? Is the code a result of trauma? An underlying Condition? How many people are still there awaiting treatemnt? What resources do you have?

And that's just to name a few.

In an ideal situation where you have enough staff there, and you have the time, give it an attempt, but they may just be gone!
 
IMO, different answer for different mech. Staffing on and on...
 
PapaBear434 said:
I'd at least do one round of CPR and drugs, so long as no one else is going critical. Depending on the situation, though. Are there more people getting hurt? Are you surrounded by fire? Are the air raid sirens going off and advising you to run to the bomb shelters?

It all depends, I guess.
Click to expand...

My overall concern is man power. How many people are you going to pull away from triaging, treating, and transporting the other patients in order to work this code? If all you are going to do is defib (if in a shockable rhythm) or hang a bag of fluids (if in PEA), then you only need one person to do either, and both should could be accomplished relatively quickly. Regardless of those interventions, it's an 'either they work or they don't' mindset, not a 'maybe the next round will be the round.' You don't want other patients dying because you're piddling around with the one that has already died.
 
In my thought processing, I was thinking that since is stated "initiated treatment", you could not change your mind and say "nevermind" its a black tag now, but rather continue the treatment you had initiated. Who knows.
 
MICs have different rules though because if you followed the normal rules, you wouldn't be able to actually triage everyone. You would have to stop and treat the first person.
 
Black tag and move on to those that are more able to be saved. MCI means you have more pt's then you have resources. If you had the staff to work the code, then it is not an MCI and you would treat as normal!
 
What's the eagerness on here to "code" people? Obvious we have little experience in regards to resuscitating people. It's an MCI. Whatever was strong enough to injure and kill them... guess what, their not going to live. Meanwhile while your coding one, another goes down the drain.

MCI.. goes into arrest it's a triage decision. their dead. Deceased, no more, out there, etc.

R/r 911
 
continue treatment--you would do the same for any of the "greens or yellows" who would suddenly code wouldn't you?
 
JPINFV said:
If the red went into arrest and there are still other patients who need to be attended to, then black tag it would be my 'by the book' answer.
Click to expand...
Unless it's a mass electrocution where reverse triage applies.
 
l14capri said:
continue treatment--you would do the same for any of the "greens or yellows" who would suddenly code wouldn't you?
Click to expand...


No you would not do the same.

If it is a true MCI, when they code, they are retriaged and become "black".

You have to do the most amount of good for the most amount of people.

I also do not like this question however because it says while you are treating a red, they become a black. Is this still a MCI or isn't it? Has more help arrived? What treatment are you giving? In a true MCI, you are not giving any treatment during the initial sort other than opening an airway and moving on or tossing them a tourniquet and saying apply this.

Granted my MCIs are way different than what most have experienced, but the procedure is still the same. They go into arrest, you move on...it is that simple.
 
In a mass cas, dead is dead...

Hyperextend head for airway and move on.
Armchairs and instructors dream up these scenarios. The armchairs go "GOTCHA", the instructors use them to springboard discussion or to introduce a concept.
Anyone see software running a dynamic simulation of a mass cas, where time and degree of injury are used alongside realistic time frames for various treatments?
 
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