Disaster Triage: सबैभन्दा बिरामीलाई पहिले भन्ने कहिलेकाहीँ गलत हुन्छ

🧠 यो किन महत्त्वपूर्ण छ

Emergency department वा वार्डमा दैनिक triage ले सबैभन्दा UNSTABLE बिरामीलाई पहिले राख्छ। MASS CASUALTY triage ले लक्ष्यलाई धेरैभन्दा धेरैको अधिकतम भलाइतर्फ पल्टाउँछ, त्यसैले स्रोतहरू मद्दत पाए बाँच्ने सम्भावना सबैभन्दा बढी भएकाहरूमा जान्छन्। START system (Simple Triage And Rapid Treatment) ले चारवटा tag प्रयोग गर्छ। RED, immediate: अहिले उपचार गरे बाँच्ने राम्रो सम्भावना भएका जीवनघातक चोटहरू। YELLOW, delayed: गम्भीर तर एक घण्टा वा बढी पर्खन सक्ने। GREEN, minor: हिँड्न सक्ने घाइतेहरू। BLACK, expectant: मृत वा हेरचाह गरे पनि बाँच्ने सम्भावना कम हुने गरी अत्यन्त गम्भीर चोट। RPM ले छुट्याउनुहोस्: RESPIRATIONS (airway खोलेपछि पनि नभए, कालो; प्रति मिनेट 30 भन्दा बढी, रातो), PERFUSION (radial pulse नभए वा capillary refill 2 सेकेन्डभन्दा बढी भए, रातो), MENTAL STATUS (सरल आदेश पालना गर्न नसके, रातो)।

Everyday triage, in an emergency department or on a unit, puts the MOST UNSTABLE client first. MASS CASUALTY triage flips the goal to the greatest good for the greatest number, so resources go to those most likely to survive with help. The START system (Simple Triage And Rapid Treatment) uses four tags. RED, immediate: life-threatening injuries with a good chance of survival if treated now. YELLOW, delayed: serious but can wait an hour or more. GREEN, minor: the walking wounded. BLACK, expectant: deceased or injuries so severe that survival is unlikely even with care. Sort with RPM: RESPIRATIONS (none after opening the airway, black; over 30 per minute, red), PERFUSION (no radial pulse or capillary refill over 2 seconds, red), MENTAL STATUS (cannot follow simple commands, red).

🏥 वास्तविक जीवनमा

🏷️ विस्फोटपछि खोपडी खुलेको चोट, pulse नभएको र agonal breathing भएको पीडितलाई कालो tag लगाइन्छ भने sucking chest wound र radial pulse भएको पीडितलाई रातो tag लगाइन्छ र उपचार गरिन्छ। Emergency department मा पहिलो पीडितले पूर्ण resuscitation पाउँथ्यो। मैदानमा नबाँच्ने चोटमा खर्च भएका मिनेटले दोस्रो पीडितको ज्यान लिन्थ्यो। नर्सको काम tag लगाउनु हो, सबैलाई छुट्याइसक्दासम्म airway खोल्ने वा ठूलो रक्तस्राव रोक्ने जस्ता छिटो जीवन बचाउने कदममा मात्र रोकिनु।

🏷️ After an explosion, a victim with an open skull injury, no pulse and agonal breathing is tagged black while a victim with a sucking chest wound and a radial pulse is tagged red and treated. In the emergency department the first victim would receive full resuscitation. In the field, the minutes spent on an unsurvivable injury would cost the second victim their life. The nurse's job is to tag, pausing only for quick life-saving steps such as opening an airway or stopping major bleeding, until everyone has been sorted.

📌 सम्झनुहोस्

• दैनिक triage: सबैभन्दा बिरामी पहिले; विपद्को triage: बचाउन सकिने पहिलेEveryday triage: sickest first; disaster triage: salvageable first
• रातो immediate, पहेँलो delayed, हरियो minor, कालो expectantRed immediate, yellow delayed, green minor, black expectant
• RPM: respirations 30 भन्दा बढी, कमजोर perfusion, वा आदेश पालना गर्न नसक्नु भनेको रातोRPM: respirations over 30, poor perfusion, or cannot follow commands means red

✅ आफूलाई जाँच्नुहोस्