Medical Triage Procedure

Before volunteers manually triage incoming requests, scripts will automatically flag requests that contain certain keywords indicating medical need.

First Steps

  1. Join the #medical slack channel

  2. Request access to the Master sheet

  3. Open the Master Rescu Doc (access in slack) and use this filter to examine only cases that require triaging:

 

Case Finders

People who are not medical professionals, but want to help find everybody the help they need.

  1. Look through the Master Rescue Doc (access in slack), and pick out entries with notes about health-related special considerations (medical needs, mobility, age) or additional comments (for example, “running out of insulin!”).

  2. If you find a case BUT cannot call, post it as a message on #medical. For example:

    1. Incident #12345 John Smith 123 Main Street, Houston, TX 555-555-5555. Two young children.

  3. IMPORTANT: Mark your case with an :arrow_right: react so that we know you’re passing it on to another case finder, and that it may not necessarily be urgent.

    1. If you’re not having any luck finding any cases on the spreadsheet, look for “arrow_right” reacts and follow up by calling those.

      1. If you follow up and all is good, use the :white_check_mark: response so we know it’s handled.

      2. If you follow up and there are problems, add a red :exclamation: react so medical professionals know to handle it. If there is a medical professional on duty, start a thread and tag them with the @ function.

  4. If you feel comfortable proceeding, go ahead and call them. If not, post in #medical to pass off to a professional!

    1. Calling.

      1. Call the contact number

        1. If you get no answer, please leave voicemail and send a text message. Please don’t use caller ID blocking. We’ve had bad luck with this.

        2. Report things like “phone disconnected” or “incorrect phone number” via the Incident Update Request form. (see slack)

      2. Mention to people that we are not 911 services, we are a volunteer-led group mapping rescue requests and coordinating with various rescue groups

      3. Find out if the person has already been rescued.

        1. If yes, yay! Update their status via the Incident Update Request form (see slack).

      4. If they have not been rescued, ask them the questions in the Medical Questions Guide. (scroll down).

      5. Learn of something that sound dangerous? Don’t know if the medicine they have will suffice? Do they need an urgent rescue? Pass it off to a medical professional!

    2. Passing off.

      1. When you find an entry that feels like it’s too complicated, post it as a message on #medical. For example:

        1. Incident #12345 Joe Smith 123 Main Street, Houston, TX 555-555-5555. Elderly couple. Both have diabetes. Have run out of insulin.

        2. Add a :exclamation: react so medical professionals know to handle it.

        3. Start a thread replying to your original message explaining the situation/answering as many questions from the list as possible to better assist the medical professionals.

  5. Information is then added to the spreadsheets then exported to the Maps

  6. Dispatchers assign Boaters to rescues based on Priority

Medical Professionals

Physicians, nurses, EMTs, and the like. Don’t know if you qualify? Better safe than sorry, stick to finding cases!

  1. When you arrive in #medical, scroll up to the last entry without either a phone react or a checkmark react.

  2. Look for exclamation point reacts. Call those people first.

  3. Then just go on down the list.

  4. Use the :telephone_reciever: react to “claim” this case/ let others know you’re working on this case.

  5. If you find the case is emergent, update their status via the Incident Update Request form, linked here.

 

Icon Meanings

Arrow Right - Case has been found, no call has been made.

White checkmark (in green box) - Call has been made, everything is ok.

Red exclamation point - call was made, case too complicated for non-professional.

Phone - medical professional is calling this entry, following up

 

Medical Questions Guide for All Callers

A quick-and-dirty yes/no triage questionnaire, linked here.

 

A more in-depth triage questionnaire below.

  1. Where is your emergency? (address and cross streets with zip code)

  2. What is the phone number you are calling from? Alternative contact number if possible?

  3. How many people are hurt? (sick)

  4. How old is the person?

  5. Is the person conscious?

  6. Is the person breathing? (able to talk?)

  7. Is the person bleeding? Where? (spray/squirt bleeding or just trickling/oozing?)

  8. Do you have any known urgent medical conditions?

  9. Are you diabetic? Do you use insulin? (if yes, how long will your insulin supply last?)

  10. Are you on oxygen? (if yes, how long will your current oxygen supply last?)

  11. Are you on dialysis? (if yes, when was your last dialysis? When are you supposed to have your next dialysis? Is your dialysis center open? Will you be able to travel to a dialysis center?)

  12. Do you take any life-saving medications and, if so, for how long do you have it in stock?

 

For people who have reported seizures:

  1. Is the reported seizure still ongoing? If not, when did it occur?
    (if still ongoing, instruct to remove hard objects/anything that can hurt them in immediate vicinity and start a timer on their phone. Important: NOT try to keep the person in place. Do NOT place your fingers in their mouth to clear airway until the seizing has stopped. If the person is laying down, lay him or her on their side, but do not force them down. Do not attempt to put anything in their mouth.)

  2. Is the person who has suffered the seizure currently conscious and breathing?
    (if not, instruct to start CPR and initiate emergency rescue)

  3. Has the person suffered any injury during their seizure?
    (if so, what kind of injury?)

  4. Has the person been diagnosed with epilepsy/other medical conditions or is this their first seizure?
    (first time seizure -> may need emergency medical attention)

  5. How long did the seizure last and is this longer than their seizures usually do?
    (if longer than 5mins or significantly longer than previous seizures -> may need emergency medical attention)

 

What is considered emergent

  • people on hemodialysis,

  • oxygen tanks running out,

  • Women in labor

  • anything where breathing is involved and possibly compromised

  • Diabetes with blood sugar over 500 mg/dl

  • HEADS UP: if you have anyone with diabetes on the phone, ask for how much longer their insulin supply lasts under normal circumstances. divide that by 2, and if the result is under 12 hours -> semi-high, under 6 hours -> high.

  • Seizures that do not stop

  • Stroke

  • Myocardial infarction

  • Unexplained loss of consciousness

  • Fever above 104 F

  • Fever above 101.5 F in infants under age 90 days

  • The combination of severe abdominal pain and vaginal bleeding in pregnant women (placental abruption)

 

Things to know

*info for helping deaf, HOH, and speech impaired in need of help/rescue*  Please let them know that Texas Relay is still up and running 24/7, so they can still make calls using their TTY machines and *should* still be able to place emergency calls through the relay service; if they do not have power to use their TTY machines, they can download an internet relay app and make calls using that system--it uses the exact same relay centers

also, please include the fact that the person is deaf, HOH, or speech impaired for the rescuers!

its no good if help comes but they aren’t rescued because no one answered after rescue called for them and there was no answer!

 

There is a list with triage colors according to urgency of the medical problems and I believe they updated this in the general channel earlier with a better description of what qualified for each color that I will try to find.

 

The medievac pink was being used for less than 2 hours of O2, diabetic without food or insulin, severe post-surgery complications, etc. that can't wait.

 

There are lots of entries in the Rescue Doc that show medical problems with very vague descriptions so those people are being called to get a list of specific symptoms, amount of meds left and other pertinent info so they can be appropriately triaged.




 

Next page:  Duplicate checking