Town Crier staff writer and photographer Ellie Van Houtte chronicles her Community Emergency Response Team (CERT) training in Los Altos Hills. Following is the second in her six-part series.
Red, yellow, green and black flags are scary to me. It’s easy to determine whether produce is edible or not, but it’s much more complex to fathom how I would methodically color-code real people to determine who should receive help first, last or never in a real-life situation that requires triage. I hope I never confront the need for triage, but if I do, my CERT training is preparing me to address the situation calmly.
My second week of CERT training focused explicitly on triage – an emergency medical response procedure that originated in France during World War I. The technique enables responders in a crisis situation to do the greatest good for the greatest number of people. When surrounded by hundreds or thousands of injured people, my role would be to canvass the incident site quickly and categorize injuries by urgency of treatment.
Even if you’ve never worked in medical services, it’s quite likely that you’ve witnessed the triage process. If you viewed video footage or photos from last week’s bombings at the Boston Marathon, you saw some of the 2,000 emergency workers on hand for the marathon bring order to a chaotic scene by quickly matching those injured victims with critical medical resources. The incredible speed and response of trained personnel on site ensured that fatalities were minimized to three, despite the more than 180 injuries.
Quick read and response
A quick check of a person’s respiration, pulmonary function and mental state is the first component of the triage routine. Expert responders can categorize people with a glance in just seconds. Using a series of verbal and physical tests – asking a question, feeling for a pulse, blanching a fingernail to test for circulation – CERT members can gauge a victim’s condition.
Using colored flags, markers or separated areas, CERT members identify the victim’s status: black for dead, red for immediate, yellow for delayed and green for minor critical needs.
Although it runs counterintuitive to my gut reaction, if I can do nothing to stabilize a dying patient, it’s my job to move on to those who have a chance of survival. When medical responders arrive, the classification system helps them focus on patients with the greatest needs and best chances of survival.
Although treatment is secondary to triage for CERT members, knowing how to locate pressure points, apply bandaging and make splints is valuable. With only 22 ambulances available in Santa Clara County at peak times of the day, according to the Santa Clara County Fire Department’s estimate, CERT members may be the only help accessible during an emergency.
Providing basic medical response to injuries often classified as the “killers” – airway obstruction, shock and blood loss – may save lives. Although the limbs lost in the Boston blast last week could not be recovered for many, the quick act of placing tourniquets on those with severe extremity damage saved lives.
CERT instructor Mike Sanders compared triage to spinning plates in the air. Managing a crisis situation would be challenging, but if I’ve practiced beforehand, the reality should be easier to control.
To read Van Houtte’s Week 3 report on fire safety, rescue equipment and cribbing, click here.