No Slide Title


	TRIAGE - HOSPITAL ARRIVALS

	Most patients arrive at the hospital within 1.5 hours of the disaster, many with only minor injuries. Arrival of these patients most often is uncoordinated (that is, they may arrive on foot, or by car, bus, ambulance or personal vehicles, and usually not in order of injury severity). During an NBC incident, casualties will require decontamination, which may lengthen the period of casualty arrival. In addition, some chemical and most biological agents may have effects which do not appear for hours or days. EDs may receive self-referred casualties over a period of days who were victims of a single incident.

	Patients usually go to the closest hospital, regardless of the level of emergency care capability, and will overwhelm one hospital, leaving other hospitals with few disaster casualties. When a hospital is faced with mass casualties presenting within a short period of time (such as after a nerve agent incident,) outside assistance from state or Federal agencies may not arrive until after the emergency response phase has passed. As a result, local communities must be self-sufficient in any type of disaster for at least the first few hours.

	After an incident involving an agent with delayed effects (such as mustard), casualties may appear at the hospital nearest their location at the time they first experience symptoms. A single hospital may therefore not experience the arrival of “mass casualties,” but only an increase in the number of patients arriving for treatment of similar symptoms.