Multiple Casualties

When you are dealing with a multiple casualty situation in a remote area, you may be required to make very difficult decisions about the treatment and evacuation of casualties. A multiple causality situation where you need to deal with more than one person is also referred to as a major incident. How serious the situation is, will depend on many factors, including the number of people you are dealing with and the age of the people, the level of injuries, the number of rescuers, whether bystanders are available, the location, the environment and weather.

If you have to deal with multiple casualties it can be easy to be tempted to approach the first person making the most noise, delaying treating someone who needs your help more. What you need to do is to quickly assess everyone’s injuries and put them into categories. This is also called triage.

There are 4 main categories, and the first is priority 1 or red group. These causalities need immediate treatment and who will be the first for the EMS to deal with or evacuate if you are in a remote location. These casualties have injuries that are life threatening or people with breathing, cardiac or circulation problems.

Priority 2 or yellow group are those who can be evacuated next. These people are those you think that you can manage until evacuation is possible. They could have serious injuries but they are stable and they are not immediately life threatening. Keep a watch over this group incase they start getting worse, so reassess where possible.

Priority 3 or the green group are those who can be classified as walking wounded and these people may also be used to treat themselves or help treat others and then evacuated last by the EMS or they may be able to walk to safety. You would not want to waste your time with this group if there are more serious problems to deal with. They may be asking for help but you will need to be in control of the system to make sure you treat the people who nee your help the most.

The final group is the dead group or white group. Unfortunately there may be someone who you cannot help and they are not able to be resuscitated.

When the EMS arrive they will carry out their own triage but the work you have done will help them in the hand over of the situation.

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