injuries and poisoning
Overview of Incidents Involving Mass Casualty Weapons
Assessment and triage
Triage is the process of assigning the degree of urgency to injuries. Some people need treatment very quickly, whereas others can safely wait for a period of time. The large number of casualties in an incident involving mass-casualty weapons requires that doctors and first responders keep initial encounters with affected people brief so that everyone can be evaluated quickly. Triage can be particularly challenging because people in mass-casualty incidents that do not involve explosions or fire may have no visible injuries. In addition, many people at or near an incident who were not exposed to the weapon may have a stress reaction (such as hyperventilation, shaking, nausea, and weakness). Stress reactions may be hard for medical personnel to distinguish from toxic, infectious, or radiological effects. Medical personnel trained in mass-casualty weapons know to set up three zones to help ensure their own safety: a hot zone, a warm zone, and a cold zone. Thehot zoneis the area immediately surrounding the release of a mass-casualty weapon. Risk to medical personnel is greatest in the hot zone, and normally, only emergency responders with appropriate personal protective equipment are allowed into this zone. Thewarm zone(decontamination corridor) borders the hot zone. Thorough, whole-body decontamination is done in this zone. Medical personnel may need to wear protective gear for primary assessment, triage, and initial treatment of casualties, especially people exposed to chemicals. Thecold zone(clean zone) includes hospital emergency departments. Because decontamination should have taken place in the warm zone, medical staff in the cold zone are normally safe with standard precautions. However, hospitals still need decontamination capability because some people may leave the scene on their own and arrive at a hospital without having been decontaminated. 