Letter Re: The Mass Casualty Incident: Triage

That was an excellent article on triage of patients in a mass casualty incident (MCI), which is also known as a multiple casualty incident. I was taught in EMT school that an MCI is any event that my truck can’t handle by itself, or an incident that overwhelms currently available resources because of the number of patients involved.

Slightly tangentially, in class one day we were talking about organ donors and I volunteered the information that I haven’t signed up as a donor. There’s no donor info on my driver’s license. However, my wife and family members have been notified and understand that I do, in fact, wish to donate my organs when the time comes, and they are to notify medical staff of that fact AFTER I expire. My classmates scoffed when I explained that emergency room staff statistically don’t try as hard to save someone who is a known organ donor as they would for someone who isn’t an organ donor. No one wants to admit this, but it’s true. I used to work in an ER X-ray department and occasionally saw similar decisions being made.

Then I got verification. On my test for the NREMT (National Registry of Emergency Medical Technicians), there was a question that I also encountered on practice tests. It’s disturbing and we didn’t cover it in class, except for my little speech. I don’t have the incorrect answers on this multiple-choice question (since I got it right) but here’s the question and the correct answer:

At the scene of a mass-casualty incident, you identify a patient as an organ donor. When triaging the other patients, you: May have to assign the donor patient a lower triage priority.

In other words, people who have made it clear on their ID or otherwise that they intend to donate their organs when they die have set themselves up potentially to receive delayed medical attention in an MCI. I assume most of my classmates missed this question if it appeared on their test, since they doubted me in class. – J.D.C. in Mississippi

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