TRIAGE

------------------------
TRIAGE SYSTEM

KEPERAWA
TAN GADAR

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 TRIAGE
TRIAGE : Adl.cara penseleksian korban berdasarkan
skala prioritas kebutuhan therapi korban
dgn.sumber daya yg.tersedia.

TRIAGE- Juga berlaku untuk penseleksian korban

untuk rujukan ke Rumah Sakit &
penanganannya.

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GAWAT DARURAT MEDIK :

• Adalah peristiwa yg.menimpa seseorang deng

an tiba-tiba dan dapat membahayakan jiwa, s
ehingga memerlukan tindakan medik dengan;
segera, cepat & tepat.

REMEMBER !!!
“ Triage is not a waste of time “
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KEBERHASILAN PENANGANAN KORBAN MASSAL DE
NGAN TRIAGE SYSTEM

• Tergantung dari :
1. ORGANISASI ( Struktural tugas )
2. FASILITAS ( Sarana & Prasarana )
3. KOMUNIKASI ( Alat, Jejaring & Prosedur )
4. DATA ( Sumber Daya Manusia )
5. PENANGANAN Operasional :
- Pra Hospital
- Intra Hospital
- Post Hospital
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 TAHAP KEGIATAN / PENANGANAN
Dengan “ TRIAGE SYSTEM “
1. AWARENESS STAGE ( Tahap Siaga )
Tahap mengetahui adanya Bencana
2. INITIAL ACTION STAGE ( Tahap aksi awal )
Tahap pengolahan informasi  Pengiriman team Adju
3. PLANING STAGE ( Tahap perencanaan )
Pecatatan data lapangan : Brp.korban ? Brp.keb.ambulan ? Logistik?
, Tenaga medik / Non medik ? Dll.
4. OPERASIONAL STAGE ( Tahap operasional )
5. FINAL STAGE ( Tahap akhir tugas )
Pencatatan & Pelaporan - Evaluasi
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 BENCANA
• BENCANA = Peristiw
a / Kejadian pd.suatu daerah yg. mengakibatkan kerusakan ekolog
i,kerugian kehidupan manusia serta memburuknya kesehatan & pe
layanan kes. yg.bermakna shg.memerlukan bantuan luar biasa dari
pihak luar
( W.H.O )

• BENCANA =
Suatu kejadian secara alami maupun ulah manusia,terjadi secara
mendadak / ber - angsur-angsur ,menimbulkan akibat yg.merugik
an shg.masyarakat dipaksa melakukan tindakan penanggulangan.
( BAKORNAS PBP )

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 KLASIFIKASI – BENCANA :

• BENCANA TK.I : KORBAN < 50 ORANG

• BENCANA TK.II: KORBAN 51-100 Org.

• BENCANA TK III: KORBAN 101-300 Org

• BENCANA TK IV: KORBAN > 300 Org.

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Types of Triages
1. Primary Triage
– to assess individual sick or injur
ed patients to determine how q
uickly medical care is needed.

o to help determine the urgency

of a patient's condition in the fi
eld

8
 CONT
2. Secondary Triage
– Secondary triage is a process
of re-evaluating a patient who
has undergone primary triage
.
– Patients involved in mass casu
alty incidents in which multipl
e people were injured, will re
ceive secondary triage by me
dical personnel before or duri
ng transport to a hospital.

9

– Once color tags have been ass
igned, basic life-saving care is
provided for patients with red
, yellow and green tags.
CONT
3. S.T.A.R.T Triage
– Simple Triage and Rapid Treat
ment (S.T.A.R.T) is a triage syst
em used by emergency medic
al technicians during mass cas
ualty incidents involving multi
ple patients
– During S.T.A.R.T triage, patient
s are given secondary triage a
ssessments
10
Goal of triage are to

• identify client with urgent, life thr

eatening conditions rapidly.
• Rate client according to priority
• Assign client to correct area of car
e
• Initiate emergency care

11
cont

• Provide on-going assessmen

t to clients
• Provide information to clien
ts and families regarding ser
vices expected care and wai
ting times.
• Provide clients education

12
Accurate assignment of triage levels ar
e based on
• Practical knowledge gained th
rough experience and training
.
• Correct identification of signs
and symptoms of condition pr
esented by clients.
• Triage guidelines and protocol
s

13
Barriers of Triage
• Languages
• Race/religion
• Stress
• Psychotic problems
• Consumption of alcohol/drugs
• Level of education
• Lack of experience / communi
cation skills
• Children without parents

14
Triage categorization
• 2 types of triage
– Field triage
– Hospital / emergency ro
om triage

15
 HOSPITAL
or
EMERGENCY ROOM TRIAGE

16
Hospital / emergency room triage
• RED /I : immediate
resuscitation

• YELLOW / II : urgent

• GREEN / III : semi-urgent

• BLUE / IV : non-urgent

• WHITE / V : dead

17
Red / I
For preservation of life. Therefore need
• Immediate resuscitation
• No delay treatment
• Example of cases:
– Cardiopulmonary arrest
– Respiratory arrest, distress, airway obstruc
tion
– Severe shock (hypovolemic, cardiogenic, et
c.)
– Acute seizure.

18
 Cont
• Trauma
– Intra-abdominal & pelvic injury
– Head injury & LOC
– Flail chest injury / tension pneumothorax

• Medical diseases:
– AMI
– Stroke
– Exacerbation of bronchiol asthma, epilepti
cus
– Poisoning
– Major burn

19
Yellow / II
• Urgent
• Need immediate treatment
• Serious problems but apparently in
a stable condition
• Should be seen within 30 minutes of
arrival

20
• Example of cases:
– Minor burn
– Spinal injury except cervical
– Bleeding less than 2 pint, fo
r exp, epistaxis
– Head injury but conscious
– Poisoning but stable
– Multiple fracture

21
GREEN / III
• Semi urgent
• Without immediate danger / distress
• Aim to be seen within 120 minutes
• Example of cases:
– Abrasions or bruises with minor bleeding
– Muscle pain or strains / minor soft tissu inj
uries.

22
BLUE / IV
• Non-urgent
• Conditions are not true accident /eme
rgency
• Should not have to wait for more than
240 minutes
• Example:
– Flu like symptoms
– Chronic diseases, eg: tonsilitis, rhinitis

23
WHITE / V
• D.O.A (Dead on Arrival)
• B.I.D (Brought in Dead)
• Usually brought in by police with
police 61 requesting post morte
m.
• Causes of death still pending

24
FIELD TRIAGE

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Field Triage
• Steps to disaster (casualties wit
h many victims)
• START (Simple Triage and Rapid
Treatment)
• Remember RPM when you are
responsible for Triage:
• R : Respiration
• P : Perfusion
• M : Mental status

26
STEP 1 in START (Simple Triage and Rapid Tr
eatment)
• Instruct client to stand up &
follow one of the team me
mber to safe area.
• Clients who able to walk an
d follow instruction will be l
abeled as GREEN
• Start assessing clients who
are lying down one by one.

27
STEP 2 in START
• Assess RESPIRATION (R of RPM)
• If not breathing
– Open airway
– Give basic life support (BLS)
• Re breathing : Label as RED
• Count RR, if:
– > 30/min : label as RED
– < 30/min : label as YELLOW
• Still not breathing : label as BLAC
K

28
STEP 3 in START

• Assess perfusion (P of RPM)

• Test capillary refill
• > 2 sec. : label as RED
• < 2 sec. : label as YELLOW

29
STEP 4 in START
• Assess mental status (M
of RPM)
• Ask simple question:
– If no response / conf
use : label as RED
– If response appropria
tely: label as YELLOW.

30
START

“If you can get up & walk, follow me”

GREEN

CHECK RPM, if unsatisfactory

RED

‘30’ & ‘2’ can do”

YELLOW

31
 WARNA PUTIH/ HITAM (HOPELESS)

• Trauma kepala dengan otak keluar

• Spinal injury dgn tidak ada lagi respon/reflek
• Meninggal dunia

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 KARTU TRIAGE

Depan Belakang 33 / 19
 KARTU TRIAGE

IM : ……… SC : ………

Depan Belakang 34 / 19
KOMUNIKASI PADA KEADAAN BENCANA YANG H
ARUS DIKETAHUI :
1. Hindari sedapat mungkin pemakaian telephone / cadangkan no.
khusus untuk masuk ke unit anda.
2. Monitor dgn.baik pesawat telephone / Radio komunikasi ,
hindari hal yg.tidak perlu krn.jalur komunikasi sangat diper-
lukan unt.hal yang bersifat darurat.
3. Laporan yg.tidak terlalu perlu dpt.dilaksanakan setelah” FASE
AKUT SELESAI “ .
4. Sebaiknya laporan disampaikan melalui faximilie.
5. Gunakan kode/ singkatan , & hanya bila anda yakin bahwa
lawan bicara anda ada dalam 1 grup / atau mengerti arti kode
ataupun singkatan tersebut.
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 PEMAKAIAN “ SANDI “ UNTU
K RADIO KOMUNIKASI
 1–1 : Menghubungi melalui telephon
 3–3 : Penerimaan sinyal jelek,tapi dapat dibaca
 4–4 : Penerimaan jelek sekali
 5–5 : Jelas / baik
 8–4 : Test radio
 8–6 : Mengerti
 8–7 : Sampaikan
 8–8 : Sibuk
 8–9 : Ingin bertemu langsung
 8 – 1 - 0 : Mati / Tidak mengudara
8 – 1 – 1 : Hidup kembali / On air
8 – 1 – 2 : Mohon diulang
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 PEMAKAIAN “ SANDI “
UNTUK RADIO KOMUNIKASI
 8–1–3 : Selamat bertugas
 8–1–5 : Cuaca
 8–1–6 : Waktu / Jam

 10 – 2 : Ada dimana
 10 – 8 : Akan ke mana
 3–3L : Kecelakaan Lalu Lintas yg,ada korban
 3–3M : Kecelakaan Lalu Lintas yg,tidak ada korban
 JAYA 65 : Musibah Kebakaran

TARUNA = BERITA / PESAN

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 HURUF ALFABHET UNT.KOMUNIKASI
‘ SANDI ORARI ‘
. A : Alfa  J : Juliet  S : Sierra
 B : Beta  K : Kilo  T : Tanggo
 C : Charlie  L : Lima  U : Uniform
 D : Delta  M : Mike  V : Valentine
 E : Echo  N : Nancy  W : Whisky
 F : Fox  O : Oscar  X : X-Ray
 G : Golf  P : Papa  Y : Yankee
 H : Hotel  Q : Quebec  Z : Zulu
 I : India  R : Romeo
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SELESAI

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