Triage / Cruciform®

International Cruciform® features

General information about the Cruciform System can be found here or by browsing the Triage/Cruciform links on the left.

Find below additional features of the International "Cruciform" card that aren't found in any other Triage Tags. Designed especially for the USA and Canada, it truly is a system not just a tag - there is seamless integration from first medical contact right through to ER admission:

  • Colour coding
  • The colour codes are clear, bright and large, ensuring no confusion as to the patient's status even from a distance.
  • Colour coding has words on it just in case someone isn’t familiar with the colour codes and as an additional backup the colours are priority numbered.
  • Ability to change the colour code as the condition changes and to document that and the reason why on the form.
  • The unique grey/black allows for identification and documentation of those patients who are expectant and provides an area for documenting pronouncement of death.
  • Each patient given a unique identification number

...which is on their wrist band and identification sticky labels. Can use the barcode if you’ve a barcode reader but the number works great for id and communicating about the patient (ie patient 00123 RED with chest injuries arriving at triage in 3 minutes).

  • Labels can be used to id the location found at scene markedly improving investigation and post-incident reconstruction which is entirely missing in north America and impedes our ability to improve care and response.
  • Labels can be used on requisitions, admissions chart, personal belongings etc..
  • Label is integrated into all aspects of the triage card so if one part comes apart somehow, it is easy to know what chart / patient it belongs to.
  • Pre-hospital and CBRNE Hazmat Casualty Assessment module
  • Clear easy CBRNE documentation and aide-memoire in one.
  • START triage documentation and aide-memoire allows for multiple recordings reflecting the reality in the field and allowing for medical personnel to see the progression and changes of the patient situation (answering that annoying question 'why' are they red/yellow etc!).
  • Simple clear documentation of field or first contact injuries uses ITLS terms that are familiar to EMS and Emergency Room personnel.

The Inner "Cruciform" part is unique in that it forms an ongoing record and chart for the patient that closely follows those used in ER's.

  • The Casualty Assessment Module on the inner left has an assessment checklist, which is known to enhance efficiency and effectiveness of care and provides easy time efficient methods of documenting patient care.
  • The Trauma Score Module employs and documents Advanced Triage scoring that provides a clear picture of the patient’s progress and means staff don’t have to refer to other references or memory for this information.
  • The Additional Observations Module allows for easy recording of orders and documentations of results/actions in one place. It also allows for documentation of family members facilitating reconciliation and reporting procedures.
  • The Casualty Details Module is designed to allow for critical information needed by police and others in identifying patients and caregivers while maintaining privacy and providing a link to existing information. This information is also helpful in post-incident reconstruction, lessons-learned and after action reporting. It is carbon copied so that those, who need to have it, can access it without needing the entire chart, protecting patient privacy while not compromising care, identification, reporting or investigating.

 

Litigation Information

The "Cruciform"® system for documenting victims has been available for over 25 years, and has been continuously revised and updated. It is acknowledged to be the most comprehensive and flexible system available, particularly for the larger incident. Unfortunately, apart from the strictly medical aspects, there are some additional factors that also need to be considered.

Naturally, rescuers do their best for victims, using the most modern techniques and procedures. They also keep their training up to date and use equipment properly. Unfortunately, after the event, perhaps even years later, memories of their expert help and kindness will have faded and the organisation the rescuer represented or who employed the rescuer on the day, may then be faced with a claim for damages.

To enable such a claim to be properly dealt with it is crucial to keep written records. Records must be made, at the time of an incident, clearly identifying what happened, where, what injuries were found and what treatment was given or advice offered.

It is also essential to identify who was involved in any treatment, relevant times, location of injured person and where they were sent. Last, but by no means least, it is vital that any record made is on a permanent medium and that it is filed away securely as a definitive record.

The Cruciform® Emergency Documentation System is designed as a permanent record. It is kept in the hospital with the patient's notes and will be filed away in secure storage.

The overlay sheet, appropriately numbered, can be kept by the employing organisation, as a record of all relevant administrative information and will, for example, also include the names of all persons who might have been involved with the victim in the field. The unique number will enable any legal team to access the full Cruciform® card from the hospital records, should that be required at any future stage. If the police keep the overlay sheet, even the numbered tag on paramedic or ambulance service records will be a unique reference to the Cruciform® held in hospital medical records stores.

Readers will be aware that in any court case, original records may be required to be produced to substantiate the facts of injuries found, treatment given and persons involved. Records kept on erasable cards will prove inadmissible, as the accuracy of the information cannot be substantiated. If a record is made on an erasable medium, the legal team may not be able to defend the rescuers' actions adequately. If the case should be lost due to inadequate record keeping, the cost could be substantial.

Could litigation affect the rescuer and/or the employing organisation? Yes, most definitely. Rescuers should be prepared for any future litigant. Use Cruciform® as the most comprehensive, medically validated and permanent record of what was done with that victim on the day so safeguard all concerned by using the finest available emergency documentation system.

 

Using "Cruciform"® Instructional Videos

A general overview of the Triage process and how to use the Cruciform Triage card and sieve.

Cruciform® for Casualty Assessment

A more detailed example of triage using the Cruciform© system process and how to use the Cruciform Triage card and sieve.

These movie excerpts are taken from the training DVD "Beyond the Call" published by the Emergency Response and Rescue Vessel Assocation Limited ERRVA and Horiizon Training Solutions Ltd., whose permission to use the clips is greatly appreciated.