How Do You Define Triage?

Triage defined in the dictionary is the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties. However, that definition can be interpreted in many different ways. Triage medical techniques were necessary during Hurricane Catrina in New Orleans. Sheri Fink explores whether or not Memorial Hospital’s doctors were following a moral code or abusing their power in her article, “The Deadly Choices at Memorial Hospital.” Memorial Hospital was in a state of panic as their power went out and resources became scarce. The only way to help patients was to evacuate them and there were limited first responders arriving at the hospital. This meant that certain patients would get to evacuate much earlier than others. This brought up the question: who gets to leave first? What choices could bring the greatest good? Did Memorial Hospital do the right thing? Memorial Hospital Doctors split their patients into 3 groups. In broad terms, Group 1 was the most healthy and Group 3 was the least healthy and required the most assistance. Group 1 patients were evacuated first, then Group 2, and Group 3 was last. This choice basically let the sickest people die. Another kind of triage would be to give resources to the people who need it most. If Memorial Hospital did that, Group 3 would be evacuated first. That would give group 3 the best chance to survive, and people who could afford to wait, would wait to be evacuated. I think that Memorial Hospital made wrong choices in how they evacuated people and also how they made their 3 categories of patients.

Many factors were taken into account by Memorial Hospital. One that I found controversial was the emphasis on DNR. Patients with DNR were automatically placed into a lower group. This meant that doctors assumed patients with DNR orders did not want to fight as much or live as much as patients without DNR. I think this a wrong assumption and that the doctors made the wrong call. DNR should not have been considered that strongly in their decision making. I believe that a DNR has no correlation to someones current happiness and love of life. Memorial Hospitals doctors were not trained properly for this situation and I believe their triage during Hurricane Katrina was immoral.

5 thoughts on “How Do You Define Triage?

  1. I agree with you that triage is a very complicated and intricate ethical problem that has been questioned for many years. In fact, the term triage was first used in World War I by French doctors in the battlefield when they were forced to decide whose lives to save in the war. Similarly, the doctors in Memorial Hospital were forced to make a decision on the day that Hurricane Katrina hit and caused a major power outage.
    Although you believe that prioritizing group 3 rather than group 1 may have been the most logical approach, I disagree with you. I believe the doctors at Memorial Hospital made the correct choice in evacuating group 1 first for several reasons. First, I believe this produces the best outcome in that more people have chances of being saved. Because they require little assistance, this allows physicians to prevent a larger number of deaths, whereas working on patients who require a lot of assistance would not allow them to save as many lives. Personally, I would rather save 500 lives than 100 lives, for example. However, DNR is very controversial as well and is interpreted in several different ways by people. I agree with you that DNR does not directly correlate to someone’s desire to live or to their happiness. Rather, I believe people choose DNR because they do not want their bodies to endure pain for a prolonged amount of time. For example, they would not want to go on life support, and they would not want to be resuscitated if they will experience a poor quality of life in the future. Thus, I agree that the doctors should not have automatically placed the patients with DNR into a lower group. If someone has a DNR order, this does not necessarily mean they do not want to live or that they require more medical assistance. This seems to be a major misunderstanding in society today. Studies have shown that simply having DNR on your medical records may automatically lead to receiving less medical attention throughout your hospital visit, which I believe is wrong.
    Thus, triage and DNR are very controversial medical issues that must be further addressed and distinguished.

  2. I would like to start off by stating that I like the way you presented your main topic of triage because it was clear to understand what you were going to talk about. Additionally, I believe the examples you used from the article to support your arguments were very strong. However, in your first paragraph, you mention several questions and I found it rather difficult to identify your main controversial question. In my opinion, I also do not agree with the chose the Memorial Hospital made in evacuating patients by categorizing them based on their DNR. This being said I believe you could use a more coherent claim to analyze. Therefore, I would like to suggest a perspective of how you could approach your question of did the Memorial Hospital do the right thing? The reason I do not believe the Memorial Hospital made a good decision was that they did not consider the fact that DNR could sometimes provide incorrect information about the patients. In an article titled “Pros and Cons of “Do Not Resuscitate” Orders in Nursing Homes” written by Walton Law Firm, he informs the reader that the people who work under medical science do not have a clear understanding of what goes on when a patient goes into a coma-persistent vegetative-state. This information is essential to your argument because it will prove to the reader that DNR is not an assertive way to declare if a patient is without hope of being rescued. At the time the doctors in the Memorial Hospital were working under pressure. This meant they did not have a clear understanding of what was the state of their patients. Furthermore, I believe that this is important to analyze because the doctors were not acting morally correct. These doctors did not consider the possibility of saving the patients because they were overwhelmed with the number of other patients they had to protect. In choosing to save the patients with a greater possibility of surviving this demonstrated that the hospital took an easier route out. Another reason the idea of using DNR to evacuate people was not the right this to do is that I would imagine that the family members of those who were in a coma had the same hope for their loved one to survive as that of other patients. In the article “The Deadly Choices at Memorial” Sheri Fink states “Angela McManus, a daughter of a patient, panicked when she overheard workers discussing the decision to defer evacuation for D.N.R. patients.” Angela McManus had hopes that her mother would be rescued but the D.N.R order snatched away all of her dreams. The reason it is important to consider Angela hopes is that it shows the lack of morality displayed by the doctors when they chose to abandon many of their patients and leave them to die. Overall I like the direction you head towards in your argument I just believe you could use more specific examples for support.

  3. تنظيفِ وتعقيمِ الخزّانِ مرّةٍ واحدة على الأقلِ كُلّ عامٍ؛ لإزالةِ الطّحالبِ والبكتيريا التي قد توجد بالخزّاناتِ. إفراغِ الخزّانِ من الماءِ قبل تنظيفه. فركِ الجُدرانِ الدّاخليّةِ السّهلةِ التّنظيفِ بقطعةِ قماشٍ نظيفةٍ وإزالةِ الأوساخِ منه، وبعد ذلك شطفِ الخزّانِ. خلطِ ملعقةٍ كبيرةٍ من محلولِ المُبيِّضِ لكُلِ جالونٍ من الماءِ المنزليّ، والانتباه إلى الأضرار التي قد تحدث من الكلور بداخل المُبيِّض، وفركِ الجُدرانِ الدّاخلية بهذا الخليطِ بقطعةِ قماشٍ نظيفةٍ وجافّةٍ، وتركه لمُدّةِ ساعتينِ وبعد انقضاءِ الوقتِ يجبُ غسلِ الخزّانِ جيّداً بالمياهِ النّظيفةِ، وبعد ذلك القيامُ بملئهِ بمياهِ الشُّربِ، ووجب التّنويه إلى ضرورةِ حصرِ المياهِ النّاجمةِ من الخليطِ لئلا يحدث الضّرر منها. تنظيفِ الخزّاناتِ التي لا يُمكنُ الوصولِ إليها من خلالِ التّأكدِ من أنّ الخزّان مُمتلئٌ بالماءِ، وبعد ذلك إضافةِ الكميّةِ المُناسبةِ من المُبيِّضِ المنزليّ وذلك حسب الكميّةِ الموجودةِ بالخزّانِ، وخلطِ المُبيِّضِ مع الماءِ إن أمكن ذلك الأمر، وغلقِ صنبورِ الخزّانِ وتركهِ لمُدّةِ 12 ساعة، وبعد انقضاءِ الوقتِ القيامِ بتصريفِ الخزّان وإعادةِ ملئهِ بمياهِ الشُّربِ مع الانتباه إلى أنّ المياهِ التي يتمّ توصيلها للخزّانِ صالحةٍ للشُّربِ وأن يتمّ الحصولِ عليها من مصدرٍ موثوقٍ ومُعتمدٍ.
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