Key Feature 7: Ask your patient if there are others needing help as a consequence of the crisis.
Skill: Patient Centered
Phase: Hypothesis generation, History
Key Feature 3: When faced with several trauma patients, triage according to resources and treatment priorities.
Okay so mass casualty trauma is not my forte. To be honest, I had to try repeated search terms in UpToDate to find content in keeping with what I was searching for. But, as it turns out, UpToDate does know a thing or two about triaging in the face of mass casualty (and almost every other medical topic you could think of). From the script of the wizards:
"Appropriate prehospital triage of trauma victims depends on a number of variables, including the nature of the incident, the number of victims, available resources, transport time, and the judgment of prehospital caretakers. As an example, triage for a motor vehicle accident with multiple victims involves determining which patients are most severely injured and ensuring that they are immediately transported to a trauma center. Priorities change during a mass casualty incident capable of overwhelming local healthcare resources. In such a circumstance, priority is placed on providing care to victims most likely to survive; victims with such severe injuries that they are unlikely to survive are given low priority because they consume a disproportionate share of resources."
The article (Prehospital care of the adult trauma patient) then goes on to identify various scoring purposes, which is beyond the scope of my interest, but which could certainly be useful in the mass casualty trauma I hope I never have to deal with. In any case, I think the above paragraph summaries the gist of things, which is that when there are a number of patients who can all receive relatively timely treatment, expedite care first for those who are at greatest threat to life and limb. (And if a solitary patient presents with a history of serious trauma, confirm there were no others injured in the event.) On the other hand, if the mass casualty trauma is so extensive compared to available resources, it may be time to adopt a Saving Private Ryan approach and probably develop PTSD after it's all said and done.