This is how it's going to work. Our ambulance bay is now our Triage. EMS will be overwhelmed. Most will probably arrive by car, several victims per vehicle. For all you newbies that don't know, Dr. Shen is our night shift attending. John, I'm gonna put you on Point Triage.
Cool.
Triage will decide who goes where depending on their injury.
Every department will have a designated primary who will oversee their staff. If you need someone, look for the vest. We're all gonna have walkies. We can get you whatever you need.
No patient goes into a room unless it's a trauma bay, and they will have four patients each. We need to keep everybody out in the open so we can keep an eye on everything, OK? Triage is gonna assess and assign every patient to a specific zone with a colored slap band. Patient who comes in with a red slap band goes to the Red Zone, which is the trauma rooms, with overflow out here. These are the most critical patients who will die without immediate attention. Samira, where are you? You are here with Dr. Abbot and me. Jack's gonna run traffic.
We have five minutes to try and stabilize the reds. After that, it's OR, ICU, or morgue.
The south and central common area over there will be the Pink Zone. That is for patients who will die in under an hour without treatment. McKay and Javadi, you are over there, with help from incoming night shift and surgical staff. Yellow Zone is the North Corridor. Those are gonna be mostly extremity wounds good vitals, talking. Mel, you're gonna run point there with Santos and Whitaker.
Uh, what if what if there's a-a pulseless extremity?
Oh, if you if you can't feel a pulse, check for Doppler flow with this. It's a mini-ultrasound. Follow the screen prompts.
But a yellow can change to a red if they go south. You got to stay on top of them, even if they seem stable.
OK, yeah.
You got this, Dr. King. Green minor lacs and sprains. They go to Family Medicine. Black and white bands are DOA, imminent death. Pedes is now our morgue. Let's hope we don't get too many of these.
We're a MASH unit now. There's no charting, no electronic medical records, no board.
How do we document treatment?
Oh, you'll all get Sharpies, and every patient has a wrist chart to document treatment and procedures. You run out of room, write on the patient's forehead.
Really?
Yeah, really.
Each wrist chart has a unique mass-casualty-incident barcode and patient number. That's how the patients are gonna get identified.
This is no-frills combat-zone medicine. No ultrasound, no X-rays, no CT, no labs. Assess based on mental status and pulse strength. Every critical patient gets an IO, intubation, a unit of blood and chest tube if needed. Everything you need blood, drugs, bandages everything will be in the Behavioral Health rooms. That's our supply depot. Um oh, keep a couple of 11 blades in your pocket. Goal is to resuscitate ASAP so they'll make it upstairs for definitive care.
Trauma surgery and neurosurgery will decide who goes up to the OR immediately and who goes to the ICU for further treatment and evaluation. Communicate. Ask for help if you need it. Trust your attendings. We will get through this together.
Damn right we will.
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