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The Challenges First Responders Face When Treating Unconscious Patients During Mass Casualty Events

Dealing with the aftermath of a natural disaster, mass shooting, multiple vehicle accident, or other mass-casualty event is one of the most stressful incidents first responders can face during their careers. Pandemonium ensues as multiple people need life-saving help at the same time and first responders may not have the resources to treat everyone at once. This guide looks at the challenges of these harrowing events and provides tips for first responders in these situations.

Securing the scene

First responders’ safety during a mass event is critical. You cannot treat victims if you are not safe, but the required safety precautions vary based on the situation. For instance, first responders need personal protective equipment when responding to chemical, biological, or nuclear attacks. They need to ensure that gunmen have been arrested after a mass shooting, and after a bombing, they need a bomb disposal expert to ensure the area is safe. 

Similarly, they need to take steps to protect themselves against buildings collapsing or smoke inhalation after a fire. These are just some of the safety elements they need to consider. Ideally, your department should develop a plan to ensure your safety before you step onto the scene of a mass casualty incident.

Handling triage in the field

First responders have to quickly prioritize the needs of victims after a mass casualty. They need to provide immediate life-saving procedures and decide which victims should be transported to the ER for more advanced treatment. 

You need a plan to deal with this process to minimize casualties and ensure that victims get the help they need as quickly as possible. There are several different types of field triage, but one of the most effective is SALT which stands for sort, assess, life-saving interventions, and treatment or transport. 

Transporting victims without overwhelming the hospital

Victims will need to be transported to a hospital after receiving emergency treatment in the field, and the main challenge at this point is ensuring that hospitals do not get overwhelmed. Walking wounded may be able to transport themselves to the ER, but if they arrive before the severely wounded, they may take up valuable resources. The sequential/conveyance method helps to minimize this effect and prevent overcrowding in the ER.

This approach may involve directing the walking wounded and transporting all other victims to a mobile emergency medical center. Then, victims with minor injuries can be treated and discharged, and people who need additional help can be stabilized and moved to the ER. Alternatively, this process can also involve stabilizing victims in a level 3 emergency department and then moving them to a level 1 trauma center as needed. 

Dealing with communication challenges

Internet or cellular networks may be out of commission depending on the type of mass casualty incident. This risk is especially high after a natural disaster. First responders need alternative communication options that rely on satellite technology, and ideally, all of the first responders in a certain area should have devices that communicate with each other. The increase in casualties after 9/11 due to the inability of different departments to communicate is a prime example of why first responders need to be proactive about communication compatibility.  

Providing help in remote locations

Access to healthcare and emergency services is always a challenge in remote areas, but this challenge is amplified during mass casualty incidents. Providing rapid responses in rural areas is difficult due to the distance between population centers, limited cell phone access, and insufficient 9-1-1 services that slow down the process of notifying first responders.  Again, proactivity is critical. 

First responders need to create a plan before disaster strikes. This should involve a team-oriented approach that involves pooling the resources of the healthcare facilities in the nearby area, conducting training drills, and developing a coordinated plan for dealing with all of the other challenges noted in this guide.

Treating unconscious patients

Many victims are often unconscious or unresponsive after a mass casualty. First responders need to help victims who are suffering mass hemorrhaging first. Then, they should work through the ABCs by checking the airways, breathing, and circulation of unconscious patients. First responders may want to use tags to label unconscious patients when they encounter them. Then, other emergency workers can deal with these victims as efficiently as possible. They don’t have to waste time ascertaining information that has already been assessed by other individuals. 

The tag system involves black, red, yellow, and green tags. Black is for deceased victims. Red means that a victim is in the midst of a dire emergency and should be treated or transported as soon as possible. Yellow refers to a serious injury but also indicates that the victim’s treatment can be delayed until the red tags have been helped. Finally, green is for the walking wounded.

Identifying victims

Dealing with unidentified victims is stressful when you just have one person in front of you, and it can be completely overwhelming when dealing with multiple victims. First responders need a plan to deal with this scenario. Ideally, they should invest in a platform that allows them to use facial recognition technology to find victims’ identities, emergency contacts, and healthcare records. 

This information is critical for ensuring that victims get the treatment that they need both in the field and the emergency room. First responders need to know about a victim’s underlying medical issues, current medications, and other information to treat them properly, and in the face of unconscious, unidentified victims, providing adequate treatment often becomes impossible. 

Improve outcomes during mass casualty incidents with ERinfoPRO

ERinfoPRO is designed to help during mass casualty incidents. This application provides first responders and emergency healthcare workers with the tools they need to identify victims, contact their loved ones, and access their medical records. 

ERinfoPRO reduces treatment time and improves outcomes and is the only medical alert service that provides first responders with access to victim emergency information through a direct connection with FirstNet®. Using ERinfoPRO is easy – simply download the app from the FirstNet® app catalog, log in with your FirstNet® credentials, take a photo of the victim, and instantly access their medical info if they are a member. To learn more, contact us today.