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This screencast shows how to use the Nuclear Detonation Scarce Resources Working Group
Triage Tool on the REMM web site. This is first page of the tool. Before using the
tool, I must assess the patient clinically using whatever trauma triage system I usually
use, for example START or SALT. Then, using the tool, I select the patient’s injury
category: Radiation only, Trauma and/or burn only or Combined injury, which is the example
used for this tutorial, and click "Next". I then estimate the radiation dose received
by the patient. Here I Insert the dose manually, 4 gray in this example. But I could also
input Absolute Lymphocyte Count values into the REMM dose calculator to estimate dose.
Then I indicate the severity of trauma and or burns: in this example, moderate trauma
with > 20% Body Surface Area thermal or radiation burn, and click "Next". I then select the
medical resource availability where I am working; Good, in this example, and click "Next". The
tool recommends 2 things for my patient: a triage category of “Delayed” and use of
"G-CSF", a myeloid cytokine, but with second order priority. Note several key points. Because
of the large mass casualty emergency, the triage category assigned may not match what
you might ordinarily expect. All patients should be re-evaluated periodically, as their
status may change The recommendations here are based on publications in 2011 from the
Nuclear Detonation Scarce Resources Working Group. This concludes the REMM screencast
about the Nuclear Detonation Scarce Resources Triage Tool from the REMM web site.