During my First Aid classes, I ask my students, "After witnessing a car accident, you choose to take action. During your scene survey and triage (prioritizing care for the injured individuals), you see three victims. A young woman screaming her head off about her broken arm, a middle-aged man standing quietly over by the curb looking disoriented, swaying, clearly having vomited, and an fidgety child playing with his PSP still securely strapped in his car seat.
Who needs your most immediate attention?"
Answers range from the amusing, "What PSP game is he playing?", to "the screaming chick obviously needs the most help. She's noisy." Still, most are surprised by the answer.
In this case, the squeaky wheel doesn't always get the grease. When prioritizing care for your patients remember that if they're screaming, they're breathing. That simple fact is a crucial determining factor during triage since well, breathing is important.
So, now we know the screaming women is breathing. Where should we look next? Some might turn their attention to the child. Pediatric patients can distract caregivers as we always want to save the kids first. While yes, their bodies are small, kids are resilient - they "bounce". They might not be as fragile as we think they are. Children haven't had the occasion to abuse their bodies as much as us older folks have, so no, don't neglect the injured child, but also don't let them draw your attention away from a possibly more injured person.
Despite his unassuming stance, the gentleman standing by the curb needs our attention first. Barring drunkenness, his unsteadiness and expulsion of stomach contents are both telltale signs of head injury. A condition we, as lay responders or spontaneous rescuers, cannot successfully treat by ourselves. We need to care for this patient within our level of training and get them to definitive medical care pronto.
Always, when you're checking your patient, keep this question in mind. What's going to kill them first? Rescuers, even seasoned professionals, can see severe bleeding and focus solely on that condition. But if they aren't breathing and have no pulse, is the application of the best pressure bandage going to save them? Yes, severe bleeding must be addressed. We all stop bleeding - eventually, so let's treat before the system empties itself, but get it dressed and move on.
Additionally, manage the scene through utilization of available resources. That will aid in the stabilization of both you, your patient and the situation. Ask bystanders to, "Please hold this here", to help apply direct pressure to bleeding wounds while you begin CPR. You'll find most people want to help, they just aren't sure what to do. Use them!
Importantly, make sure someones called 911 or the local emergency assistance number. How many times have I happened upon an accident scene minutes after the incident only to find everyone paralyzed by indecision. I ask, "Who's called 911?" Silence. That's not a good feeling. Your patient's life depends on those precious minutes, and the clock starts ticking not when the ambulance arrives, but at initial injury. Give them the best chance for a positive outcome. If you do nothing else, make sure help is on the way.
True, we won't always make the right triage decision. All we can do is think, act, and do our best with the knowledge we possess. Something is always better than nothing. Simply comforting the patient; letting them know you're there and that help is on the way does a world of good. So arm yourself with knowledge and the physical tools to perform your skills; the feeling of empowerment is amazing. You really can save lives.
Learn to care for these conditions by participating in a CPR and First Aid class. Here are some useful links:
American Heart Association's Find a CPR class link.
American Red Cross's Take a class link.
or Find a CPR class in your area by clicking here.
And to make sure you're ready with the right tools, visit our store.