17. 3-Level-Criteria of Triage
Level 1 Critical – Severe medical problems
eg. poisoning , overdose ,
– Unconscious , GCS < 8 cardiac and diabetic
– Airway problem esp. complications
cyanosis , stridor in a child – Emergency childbirth ,
– Cardiac or respiratory arrest complications of pregnancy
, hemorrhage , or
– RR < 10 or > 30 c / s indications of eclampsia
cyanosis
– Severe psychiatric
– Weak irregular pulse or PR problems : suicidal attempt
< 50 /min , > 150 / min or , aggressive behaviour
pulseless
• Multiple injuries
– SBP < 90 mmHg or no – Cervical spine injury
palpable radial pulse in
– Severe head injury
children
– Open chest or abdominal
– Shock of any types wounds
– Severe uncontrolled – Burn partial or full > 20 % in
bleeding adults or > 10 % in children
– Seizure
18. 3-Level-Criteria of Triage
Level 2 Urgent
• Continuous nausea, vomiting or
diarrhea Level 3 Non-urgent
• Body temperature > 39 C • Non-acute abdominal pain,
• Acute panic states , drug overdose
back pain
, suspected poisoning
• Eye & ENT problem: hyphema , • Chronic conditions :
ocular rupture, retinal detachment headache , backache
(Dx by poor vision , acute
• Sore throat , cough
glaucoma , epistaxis)
• Multiple fracture without sign of • Mild anxiety
comparment syndrome • Minor injuries
• Burn patient (not severe as
• Death on arrival (DOA)
assessed in level 1)
• Acute headache
• Acute abdominal pain , back pain
20. • Advanced cardiac Life Support
• Pediatric Advanced Life Support
• Advanced Trauma Life Support
• Advanced Pre-Hospital Life support
• HAZMAT Life Support
Thai Advanced Life Support
21. Consideration of Treatment
• Resuscitation (Refer for immediate
treatment)
• Do not delay treatment
• Refer for treatment as soon as possible
• Reassess while waiting
• Rapid step test
• Offer comfort measures
23. ตัวอย่างของการพัฒนา เพื่อให้เกิด “การรักษาทันที”
• Pre-Hospital
• In-Hospital
– Fast Track, Protocol or Guidelines
– Equipment for Emergency Procedures:
Equipment for Difficult Intubation,
Defibrillator, ICD, Cricothyroidotomy,
Intraosseous Infusion, etc.
– Investigation: Point of Care, Ultrasound
– Monitoring for Patient Assessment
– Medications
– Blood Component: Group O Adsol