Page 626 - Clinical Application of Mechanical Ventilation

592 Chapter 18

START TRIAGE
All walking wounded

MINOR
RESPIRATIONS

NO YES
Position airway

NO YES Under Over
30/min 30/min
DECEASED IMMEDIATE
IMMEDIATE

PERFUSION
Radial pulse present
Radial pulse
absent
OR
Capillary refill
Over Under
2 seconds 2 seconds
The SALT triage Control
algorithm (Figure 18-3) bleeding MENTAL STATUS
incorporates triage with
life-saving interventions (LSI):
control of major hemorrhage,
opening of airway, chest IMMEDIATE
decompression, and auto
injector antidotes. Can't follow Can follow
simple simple
commands commands © Cengage Learning 2014

SALT: a mass casualty triage IMMEDIATE DELAYED
algorithm consists of Sort, Assess,
Life-saving interventions, and Figure 18-2 START stands for Simple Triage and Rapid Treatment. Immediate has a highest
Treatment/Transport.
priority of care than Delayed and Minor.

SOFA: the Sequential Organ
Failure Assessment (SOFA) score scientific information and developed SALT (Lerner, 2008). SALT (Sort, Assess, Life-
is a triage system that uses six saving interventions, Treatment/Transport) is a mass casualty triage algorithm
criteria to predict the outcomes of
critically ill patients in the hospital. (Figure 18-3) that incorporates triage (sort) with immediate life-saving interven-
tions (LSI). LSI includes control of major hemorrhage, opening of airway, chest
decompression, and auto injector antidotes. Like START and JumpSTART, SALT
The SOFA scoring system is used as an in-the-field (prehospitalization) triage system.
is developed to assess hospi-
talized patients. For patients Triage System for Hospitalized Patients. The Sequential Organ Failure Assessment
presenting with sepsis or
evidence of hypoperfusion, (SOFA) score (mdcalc, 2011) in Table 18-4 is a triage system for hospitalized pa-
SOFA may be an appropriate tients. It was created in a consensus meeting of the European Society of Intensive
assessment tool for initial and
ongoing ICU assessments. It Care Medicine in 1994, and further refinements were made to it in 1996. SOFA
may serve as a predictive and uses six criteria to predict the outcomes of critically ill patients in the hospital (Fer-
prognostic model for critical
care clinical outcomes. reira et al., 2001; Jones et al., 2009). The SOFA scores are used to prioritize patient
care based on available resources. For patients presenting with sepsis or evidence of

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