Major Incident Planning and Support (MIP+S) Level 3

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Secondary Triage - example

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5 min 5 sec
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Secondary Triage: Assessing Patient Severity

Understanding Secondary Triage

Secondary triage, also known as triage sort, involves assessing a patient's condition to determine their triage category. This process is essential for prioritising medical care effectively.

Assessment Process and Scoring

The assessment involves scoring the patient using the Glasgow Coma Scale (GCS) and translating this into a Revised Trauma Score to assign a triage category.

Example 1: Patient Assessment

  • GCS Assessment:
    • Eye-opening to pain: Score of 2
    • Verbal response (incomprehensible): Score of 2
    • Motor response (flexing to pain): Score of 3
    • Total GCS score: 7
  • Physiological Parameters:
    • Respiratory rate: 19 (score of 4)
    • Systolic blood pressure: 127 (score of 3)
    • Revised Trauma Score: 10 (Category 1 patient)

Example 2: Patient Assessment

  • GCS Assessment:
    • Eye-opening spontaneous: Score of 4
    • Verbal response (oriented): Score of 5
    • Motor response (obeys commands): Score of 6
    • Total GCS score: 15
  • Physiological Parameters:
    • Respiratory rate: 14 (score of 4)
    • Systolic blood pressure: 120/80 (score of 4)
    • Revised Trauma Score: 12 (Priority 3 patient)

Example 3: Patient Assessment

  • GCS Assessment:
    • Eye-opening spontaneous: Score of 4
    • Verbal response (oriented): Score of 5
    • Motor response (obeys commands): Score of 6
    • Total GCS score: 15
  • Physiological Parameters:
    • Respiratory rate: 13 (score of 4)
    • Systolic blood pressure: 110/85 (score of 4)
    • Revised Trauma Score: 12 (Priority 3 patient)

Clinical Decision Making

Secondary triage should be conducted by trained clinicians due to its critical nature in determining patient prioritisation. Clinicians use an algorithm to decide whether to upgrade or downgrade a patient's priority based on additional injuries or conditions.

Case Example Insight

In cases involving severe burns to the airway or face, clinicians may upgrade a patient's triage category for immediate attention, even if their initial score suggests a lower priority.