EM Vivas · Disaster and mass casualty
Mass casualty — START/SALT and the non-treating commander
Clinical viva on MCI triage, ICS and population ethics.
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Study tools
Target exams
ACEMFRCEMABEM
Prompt
Code disaster: 25 casualties expected from a train derailment. First walking wounded are already in the waiting room. Outline triage, command and ethical priorities.
Interpretation
Reveal interpretationShowHide
Declare MCI; activate plan; establish Incident Commander who coordinates and does not treat. Sort with SALT/START: Immediate, Delayed, Minimal, Expectant. Continuous retriage. Expect critically injured later by ambulance. Population ethics — greatest good for greatest number; document expectant care; control decon if CBRNE risk.[1][2]
References3ShowHide
- [1]Lerner EB, Schwartz RB, Coule PL, et al. Mass casualty triage: an evaluation of the data and development of a proposed national guideline. Disaster Med Public Health Prep, 2008.PMID 18769263
- [2]Lerner EB, Schwartz RB, Coule PL, et al. Use of SALT triage in a simulated mass-casualty incident. Prehosp Emerg Care, 2010.PMID 19947863
- [3]Sarin RR, et al. Core Disaster Medicine Education (CDME) for Emergency Medicine Residents in the United States. Prehosp Disaster Med, 2019.PMID 31455462