Dr. Donald Blake & Thor Odinson (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
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fandomhigh2025-07-18 09:37 am
ifwebeworthy) wrote in fandomhigh2025-07-18 09:37 am
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First Aid 2: First Aider, Friday, Period 3
"Today," Don greeted his students, "I thought we should go over triage.
"Sounds fancy, right? It's French, it's meant to sound fancy, but really 'triage' just means 'to sort.' You'll mostly encounter triage in situations where multiple people are injured, but it can also be helpful to keep in mind one-on-one when you're evaluating how badly someone is injured. There are five levels of triage, based on how urgent the patient's need for care is. Proper triage is important, because injuries can look scary but not be that serious--like a scalp wound, right? Anybody here ever seen somebody with a scalp wound? They bleed like hell, super dramatic, blood everywhere, but as long as it's just a scalp wound and not deeper head trauma, it's just superficial. They're probably not actually going to lose enough blood to die, or even to need a transfusion. Throw some stitches in there and they're good to go. Alternately an injury can not look that serious and turn out to be a major thing, which is why you shouldn't stop paying attention to your patients after you've done initial triage, but that's not today's class.
"So the first thing you're going to evaluate is, are they dead? Technically anyone who's already dead is in the category of least concern, but that's not really true, because under certain circumstances you can fix dead, which moves those people into the area of highest concern. So you've got to look at what's happened. Is it a cardiac event, hypothermia, drowning? Have they only been clinically dead for a short amount of time? Then by all means, get in there with your CPR and your rescue breathing or your extremely controlled raising of body temperature. You gotta at least try. But know your priorities. If you're doing CPR on a guy who can maybe be saved for twenty minutes and that means another patient who definitely could have been saved bleeds out with no one to tend to them..." He trailed off and let them imagine the end to that sentence for themselves.
"The next thing to look at is, can they get up and walk? Anyone who can is automatically low urgency. They're what's called the 'walking wounded.' They may need medical treatment, but it can wait, possibly several hours if necessary. The next question is, why can't they walk? Do they have a broken ankle? That person can wait, too, but maybe not as long as the other guy. Do they have a serious injury, but the bleeding's stopped? Is it maybe a spinal injury? They go ahead of the guy with the broken ankle, so that's another level. The next level is people whose lives are in immediate danger. They're heavily bleeding, their airway or breathing is compromised, they're unconscious or unresponsive. Those are the people you treat first and everybody else can wait no matter how much they complain.
"This all sounds very serious, because it is, and when I'm talking about the levels in terms of, 'is someone's life in danger or not?' it maybe sounds like it won't ever apply to you. I hope that criteria won't. But there are a lot of times in normal life when it can apply. Say your two friends are real klutzes in the kitchen and one of them burns his hand at the same time the other one cuts hers. Who do you deal with first? Bleeding trumps not bleeding, so tell him to stick his hand under cold water while you wrap hers in a dish towel and try to get the bleeding stopped--and if she lost any parts of that finger, get 'em on ice and get her to the ER. If the bleeding won't stop: ER. Stitches. Now, if his burn is second- or third-degree, that's another story, but, y'know, use your common sense. I hope you have some.
"Now. Does anybody have any questions?"
"Sounds fancy, right? It's French, it's meant to sound fancy, but really 'triage' just means 'to sort.' You'll mostly encounter triage in situations where multiple people are injured, but it can also be helpful to keep in mind one-on-one when you're evaluating how badly someone is injured. There are five levels of triage, based on how urgent the patient's need for care is. Proper triage is important, because injuries can look scary but not be that serious--like a scalp wound, right? Anybody here ever seen somebody with a scalp wound? They bleed like hell, super dramatic, blood everywhere, but as long as it's just a scalp wound and not deeper head trauma, it's just superficial. They're probably not actually going to lose enough blood to die, or even to need a transfusion. Throw some stitches in there and they're good to go. Alternately an injury can not look that serious and turn out to be a major thing, which is why you shouldn't stop paying attention to your patients after you've done initial triage, but that's not today's class.
"So the first thing you're going to evaluate is, are they dead? Technically anyone who's already dead is in the category of least concern, but that's not really true, because under certain circumstances you can fix dead, which moves those people into the area of highest concern. So you've got to look at what's happened. Is it a cardiac event, hypothermia, drowning? Have they only been clinically dead for a short amount of time? Then by all means, get in there with your CPR and your rescue breathing or your extremely controlled raising of body temperature. You gotta at least try. But know your priorities. If you're doing CPR on a guy who can maybe be saved for twenty minutes and that means another patient who definitely could have been saved bleeds out with no one to tend to them..." He trailed off and let them imagine the end to that sentence for themselves.
"The next thing to look at is, can they get up and walk? Anyone who can is automatically low urgency. They're what's called the 'walking wounded.' They may need medical treatment, but it can wait, possibly several hours if necessary. The next question is, why can't they walk? Do they have a broken ankle? That person can wait, too, but maybe not as long as the other guy. Do they have a serious injury, but the bleeding's stopped? Is it maybe a spinal injury? They go ahead of the guy with the broken ankle, so that's another level. The next level is people whose lives are in immediate danger. They're heavily bleeding, their airway or breathing is compromised, they're unconscious or unresponsive. Those are the people you treat first and everybody else can wait no matter how much they complain.
"This all sounds very serious, because it is, and when I'm talking about the levels in terms of, 'is someone's life in danger or not?' it maybe sounds like it won't ever apply to you. I hope that criteria won't. But there are a lot of times in normal life when it can apply. Say your two friends are real klutzes in the kitchen and one of them burns his hand at the same time the other one cuts hers. Who do you deal with first? Bleeding trumps not bleeding, so tell him to stick his hand under cold water while you wrap hers in a dish towel and try to get the bleeding stopped--and if she lost any parts of that finger, get 'em on ice and get her to the ER. If the bleeding won't stop: ER. Stitches. Now, if his burn is second- or third-degree, that's another story, but, y'know, use your common sense. I hope you have some.
"Now. Does anybody have any questions?"
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His life was a horror show.
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Because it definitely did to Flint.
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Which just meant it would be good and ready for more notes on everyone else's questions!
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