“CODE TRIAGE. APPROXIMATELY TWENTY-FIVE PATIENTS, FIVE MINUTES.”
The operator's piercing voice cut through Angela's thoughts. God, please help me! she cried silently. With her head throbbing from its bump against the desk, she recovered the policy for triage out of the drawer. This is the absolute worst moment to be relief charge!
The earthquake shook her to the core.
Two weeks of orientation could not prepare her for the moments to come. Triage meant life and death decisions – more so than any other emergency room experience. Grabbing the list, she made her way to the front doors, checking on staff as she walked.
“Everyone okay? Any injuries?” She noted many nurses and aides rubbing their heads and limbs.
“Just bruised,” said Jeri. “Ang, what are we going to do with the patients we have?”
“Move them to the cafeteria as soon as possible. With no trauma patients at the moment, we need to have every room cleared for what's coming.” Reviewing the sheet, she quickly added, “Give them all green bands – they can be checked later on.”
Angela made mental notes of where to direct the patients. Green – walking wounded – to the cafeteria. Yellow – delayed – to the waiting room. Red – immediate – to all available rooms. Black – dead, or expected to die – to the morgue.
The awful truth churned her stomach, as she realized the ethical implications of her responsibility. Anyone she designated with the black band would normally be treated first in the ER. In a triage situation, though, the reduced resources and lack of time forced them to focus on those who were more likely to live. They could not waste any time or resources on a patient who would possibly die even with their help.
The first patients wandered through the doors, clutching arms, heads, and stomachs. “Head laceration – cafeteria. Broken arm – cafeteria. Stomach blow – wait,” she checked the list. Yellow. “Possible internal injury – waiting room.” Staff members directed each patient as she placed tape on their wrists.
God, please help me! Looking up, she noted the next one on a stretcher. Blood soaked through a makeshift bandage around a compound leg fracture. “Immediate treatment – take him to Room 9.” Placing a red band, she indicated the route.
More head lacerations, broken bones, complaints of chest pain continued to roll in. Angela felt more confident as she designated each one with the green and yellow tape. Fewer red patients came at first, but as the minutes passed, the paramedics began to bring those who could not bring themselves. Severe blood loss and punctures wounds began to fill the rooms. Staff called for emergency blood supplies and medications as quickly as the lab and pharmacy could supply them.
And then a man with eighty percent burns on his body – the first black band. With trembling hands, Angela wrapped a black band on his wrist. “Take him to the morgue, and if you have any morphine to spare, give him a dose.”
More red bands. A few yellow. Next, a woman barely breathing with a rapid, thready pulse. When the woman did not stir, Angela quickly wrapped the black band on her wrist.
Minutes passed, turning to hours. The patients kept coming in, and she replaced rolls of tape as quickly as she used them. As the hours passed, the conditions of those arriving changed from wounded to critical. “Black. Next – red. Next – black. Next – black.” She fought tears as she wrapped black bands around patient after patient.
Black. Could any other color induce a greater feeling of hopelessness? As Angela banded patient after patient, she pondered the inevitability of death.
Another one. The boy stared at her with wide eyes. His wounds were deep, complicated by burns all over his body. An almost certain fatality. She hesitated, hating that she had to wrap his wrist in black. It's not fair, God. He's just a boy! Someone's precious child, and for us, not worth saving.
The stretcher team looked at her expectantly. She had the power of decision – would she direct all of their limited resources to saving this one child?
Slipping the red tape on his wrist, she pointed the way. Please God, make this worth it.
For a brief moment, she grasped the truth of her salvation. Those designated by black, bound for certain death, God chose for salvation by the red band of Jesus' blood.
She paused, lifting a silent prayer. Thank you so much, God, for not putting that black band on me!
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