Problems of triage during an emergency involving disabled people

Mass casualty incidents and their occurrence are a real threat not only to the society as a whole but also to emergency medical service providers, who, at the moment of the occurrence of a mass casualty incident, must completely change their approach to providing care and switch into the emergency regime. At that moment, high demands are placed on the entire integrated rescue system, both with regard to ensuring safety, preventive measures and organizing activities at the site of the mass casualty incident, andto providing quick and expert assistance. This bachelor thesis concerns mainly providers of emergency medical services during mass casualty incidents and problems of sorting of casualties. In case of a mass casualty incident, the situation requires a completely different approach to the treatment of the casualties than everyday work. In this situation, the individual medicine model when the emergency medical crew provides care to one patient only, from the initial contact to the transfer of the patient to a medical facility, does not apply. In a regime of mass casualty incident, it is necessary to set priorities for treatment, to carry out such treatment and transport the patient to a medical facility. The priority in such a situation is not to save everyone's life, but to eliminate the extent of injuries of the people to the minimum. The treatment of casualties at the site of a mass casualty incident is complicated by many factors that negatively affect the situation. In particular, there is a lack of time for decision-making and treatment, chaos, stress, panic, and in the initial phase also a lack of resources and forces, concerning not only the providers of emergency medical services, but the entire integrated rescue system. Since the on-site situation is optimized within thirty and sixty minutes of the start of operations, it is crucial in the initial phase to focus on the organization and management of the integrated rescue system units. The bachelor thesis is devoted to the issue of classification of the casualties on the site of amass casualty incident. The theoretical part deals with the topics of disaster medicine, the integrated rescue system and in the last part it is devoted to the classification itself. The theoretical part is based on expert literature and current legislation. In the part focused on the classification of the casualties, the individual methods for classification of casualties and scoring systems are analysed in detail, especially the START method and classification identification card, which dominate in our country. The practical part of the thesis is done in the form of qualitative research and compares the answers obtained by a semi-structured interview with two groups of respondents. Respondents were non-doctor medical personnel of the emergency medical service, one group from the Vysočina Region and the other from the South Bohemian Region. The content of the interview was divided into four categories, each focusing on a particular area of casualty incidents. The individual categories dealt with general and specific procedures at the site of a mass casualty incident, cooperation of the integrated rescue system and the issue of classification of patients. The aim of this thesis was to find out how the rescue workers are prepared for a mass casualty incident both theoretically and practically, how they evaluate the cooperation within the whole integrated rescue system. The aim of the thesis was also to verify the theoretical knowledge of the respondents concerning this area of interest and the procedures. The results obtained by the interview and their analysis are included in the chapter Vyhodnocení rozhovorů. The research questions and their results are discussed in the chapter Diskuze. The overall conclusion is included in the chapter Závěr