Casualty management in field missions is complex and challenging due to themultiple tasking

involved. The existing policy requiring both clinical and administrative procedures has been
prepared comprehensively forits effective and efficient delivery.

Se Subject Existing policy Comments/ suggestion

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1. Golden The golden hour principle aims to The golden hour principle aims to
Hour provide skilled first aid bytrained provide skilled first aid bytrained
Concept non-medical staff, paramedics, non-medical staff, paramedics,
medics or nursing assistants within medics or nursing assistants within
10 minutes of atrauma injury or 5 minutesof atrauma injury or onset
onset of symptoms, and advanced of symptoms, and advanced life
life support by medical support by medical professionals as
professionals as soonas possible, soonas possible, but not exceeding
but not exceeding one hour. 30 mins.
2. Golden Usually, medical emergencies Usually, medical emergencies such
Hour such as acute myocardial as acute myocardial infarction,
Concept infarction, cerebro-vascular cerebro-vascular accidents, etc., will
accidents, etc., will be referred to a be referred to a Level 3 or 4 hospital
Level 3 or 4 hospital after after stabilization in a Level 1/initial
stabilization in a Level 1. management in level
Surgicalemergencies such as 2.Surgicalemergencies such as
injuries with or without severe injuries with or without severe
bleeding should be referred to a bleeding should be referred to a
Level 2 medical facility for damage Level 2 medical facility for damage
control surgery after stabilization at control surgery after stabilization at
the incident site. the incident site.
3. Evacuation Casualty evacuationsshall be Casualty evacuationsshall be
time to completed within 60 minutes of completed within 30 minutes of
medical occurrence of the life-threatening occurrence of the life-threatening
facility injuries. injuries.
4. Simple Simple triage is also referred to by Simple triage is also referred to by
triage the acronym S.T.A.R.T, which the acronym S.T.A.R.T, which
stands for SimpleTriage and Rapid stands for SimpleTriage and Rapid
Treatment. This is a simple triage Treatment. This is a simple triage
system that can be performed system that can be performed
bylightly trained lay and bylightly trained lay and emergency
emergency personnel in personnel in emergencies
emergencies (paramedics). (paramedics). Simpletriage is
Simpletriage is typically used at typically used at the scene of an
the scene of an accident or MCI, in accident or MCI, in order to sort
order to sort patientsinto those patientsinto those who need critical
who need critical attention and attention and immediate transport to
immediate transport to the hospital the hospital andthose with less
andthose with less serious injuries. serious injuries. This step along
This step can be initiated before with Rapid Treatment must be
transportationbecomes initiated immediately before
available.The categorization of transportationbecomes
patients based on the severity of available.The categorization of
theirinjuries can be aided with the patients based on the severity of
use of printed triage tags or theirinjuries can be aided with the
 coloured flagging. use of printed triage tags or
coloured flagging.
5. Policies It is essential that the patients pre- It is essential that the patients pre-
and evacuation and in-flight treatment evacuation and in-flight treatment is
procedure is adequatelydocumented and if adequatelyadministered and
s indicated, travel of an documented and travel of an
concerning accompanying doctor or nurse accompanying doctor or nurse must
MEDEVAC may beauthorized. beauthorized.