The final sample consisted of 11 triage trained ED RNs (FG #1 four participants, FG #2 three participants, and FG #3 four participants). All participants were female, with a mean age of 39 years; with on average 14 years of experience as an emergency RN, and 7 years of experience in triaging. Between Jan 1, 2015, and Dec 31, 2017, 12 915 children (median age 103 years, IQR 42–136) were transported to the emergency department with injuries. 4091 (317%) patients were admitted to hospital, of whom 129 (32%) patients had an ISS of 16 or greater and 227 (55%) patients used critical resources within a limited timeframe. Carpenter-type nails about 1 to 2.5 centimeters (0.4 to 1.0 in) long. Similar objects were found at the scene. The New York Times stated that, according to doctors, because the bombs were low to the ground, the injuries mainly affected legs and feet instead of abdomens, chests, and heads, and as a result few deaths occurred.
Andrew Dalke and Raymond Hettinger
0.1
Python lists have a built-in
list.sort()
method that modifies the listin-place. There is also a sorted()
built-in function that builds a newsorted list from an iterable.In this document, we explore the various techniques for sorting data using Python.
Sorting Basics¶
A simple ascending sort is very easy: just call the
sorted()
function. Itreturns a new sorted list:You can also use the
list.sort()
https://timefree.mystrikingly.com/blog/descargar-sugar-smash. method. https://davidtorrent.mystrikingly.com/blog/how-to-play-free-slots-online. It modifies the listin-place (and returns None
to avoid confusion). Usually it’s less convenientthan sorted()
- but if you don’t need the original list, it’s slightlymore efficient.Another difference is that the
list.sort()
method is only defined forlists. In contrast, the sorted()
function accepts any iterable. Perfect horizon 1 0 16.Key Functions¶
Both
list.sort()
and sorted()
have a key parameter to specify afunction (or other callable) to be called on each list element prior to makingcomparisons.Buffalo slots online. For example, here’s a case-insensitive string comparison:
The value of the key parameter should be a function (or other callable) thattakes a single argument and returns a key to use for sorting purposes. Thistechnique is fast because the key function is called exactly once for eachinput record.
A common pattern is to sort complex objects using some of the object’s indicesas keys. For example:
The same technique works for objects with named attributes. For example:
Operator Module Functions¶
The key-function patterns shown above are very common, so Python providesconvenience functions to make accessor functions easier and faster. The
operator
module has itemgetter()
,attrgetter()
, and a methodcaller()
function.Using those functions, the above examples become simpler and faster:
The operator module functions allow multiple levels of sorting. For example, tosort by grade then by age:
Ascending and Descending¶
Both
list.sort()
and sorted()
accept a reverse parameter with aboolean value. This is used to flag descending sorts. For example, to get thestudent data in reverse age order:Sort Stability and Complex Sorts¶
Sorts are guaranteed to be stable. That means thatwhen multiple records have the same key, their original order is preserved.
Notice how the two records for blue retain their original order so that
('blue',1)
is guaranteed to precede ('blue',2)
.This wonderful property lets you build complex sorts in a series of sortingsteps. For example, to sort the student data by descending grade and thenascending age, do the age sort first and then sort again using grade:
This can be abstracted out into a wrapper function that can take a list andtuples of field and order to sort them on multiple passes.
Vuescan 9 5 15 – scanner software with advanced features. The Timsort algorithm used in Pythondoes multiple sorts efficiently because it can take advantage of any orderingalready present in a dataset.
The Old Way Using Decorate-Sort-Undecorate¶
Triage 1 0 14 Meters Equals
This idiom is called Decorate-Sort-Undecorate after its three steps:
- First, the initial list is decorated with new values that control the sort order.
- Second, the decorated list is sorted.
- Finally, the decorations are removed, creating a list that contains only theinitial values in the new order.
For example, to sort the student data by grade using the DSU approach:
This idiom works because tuples are compared lexicographically; the first itemsare compared; if they are the same then the second items are compared, and soon.
It is not strictly necessary in all cases to include the index i in thedecorated list, but including it gives two benefits:
- The sort is stable – if two items have the same key, their order will bepreserved in the sorted list.
- The original items do not have to be comparable because the ordering of thedecorated tuples will be determined by at most the first two items. Doubledowncasino on facebook. So forexample the original list could contain complex numbers which cannot be sorteddirectly.
Another name for this idiom isSchwartzian transform,after Randal L. Schwartz, who popularized it among Perl programmers.
Now that Python sorting provides key-functions, this technique is not often needed.
The Old Way Using the cmp Parameter¶
Many constructs given in this HOWTO assume Python 2.4 or later. Before that,there was no
sorted()
builtin and list.sort()
took no keywordarguments. Instead, all of the Py2.x versions supported a cmp parameter tohandle user specified comparison functions.In Py3.0, the cmp parameter was removed entirely (as part of a larger effort tosimplify and unify the language, eliminating the conflict between richcomparisons and the
__cmp__()
magic method).In Py2.x, sort allowed an optional function which can be called for doing thecomparisons. That function should take two arguments to be compared and thenreturn a negative value for less-than, return zero if they are equal, or returna positive value for greater-than. For example, we can do:
Or you can reverse the order of comparison with:
When porting code from Python 2.x to 3.x, the situation can arise when you havethe user supplying a comparison function and you need to convert that to a keyfunction. The following wrapper makes that easy to do:
To convert to a key function, just wrap the old comparison function:
In Python 3.2, the
functools.cmp_to_key()
function was added to thefunctools
module in the standard library.Odd and Ends¶
- For locale aware sorting, use
locale.strxfrm()
for a key function orlocale.strcoll()
for a comparison function. - The reverse parameter still maintains sort stability (so that records withequal keys retain the original order). Interestingly, that effect can besimulated without the parameter by using the builtin
reversed()
functiontwice: - The sort routines are guaranteed to use
__lt__()
when making comparisonsbetween two objects. So, it is easy to add a standard sort order to a class bydefining an__lt__()
method: - Key functions need not depend directly on the objects being sorted. A keyfunction can also access external resources. For instance, if the student gradesare stored in a dictionary, they can be used to sort a separate list of studentnames:
You are here:Home >Triage Guidelines
Triage of Chemical Casualties
General principles of triage for chemical exposures
- Check triage tag/card for any previous treatment or triage.
- Survey for evidence of associated traumatic/blast injuries.
- Observe for sweating, labored breathing, coughing/vomiting, secretions.
- Severe casualty triaged as immediate if assisted breathing is required.
- Blast injuries or other trauma, where there is question whether there is chemical exposure, victims must be tagged as immediate in most cases. Blast victim's evidence delayed effects such as ARDS, etc.
- Mild/moderate casualty: self/buddy aid, triaged as delayed or minimal and release is based on strict follow up and instructions.
- If there are chemical exposure situations which may cause delayed but serious signs and symptoms, then over-triage is considered appropriate to the proper facilities that can observe and manage any delayed onset symptoms.
- Expectant categories in multi-casualty events are those victims who have experienced a cardiac arrest, respiratory arrest, or continued seizures immediately. Resources should not be expended on these casualties if there are large numbers of casualties requiring care and transport with minimal or scant resources available.
- In a given category prioritize a child, pregnant woman over an non-pregnant adult
Chemical agent-specific triage
See Triage Sections of Prehospital and Hospital Management:
Key Activities for Triage 1
- The dose determines the poison during triage. Determining if a patient had direct contact (e.g., splash or skin contact) and the relative distance from areas with the highest concentrations (e.g., near the source of a leak or spill) can guide triage decisions, just like principles of radiation dose delivery (i.e, time, shielding, distance) apply to many mass chemical events.
- Obtaining history about the time a patient was in a toxic environment and the distance from the areas of greatest concentration can help to stratify patients into high-risk and low-risk groups. This approach is similar to using an account of the mechanism of injury to anticipate injuries even before the clinician touches the trauma patient.
- Understanding the different mechanisms of trauma (e.g., speed of the vehicle, presence of fatalities in the same accident, or height of a fall) and the predictable pattern of injuries that may result will influence the patient's evaluation and affect care. This approach is not an absolute solution for poisonings but is potentially valuable for mass chemical exposures whereby triaging patients is critical to quickly find those most at risk for serious illness.
- In addition to triage, the same principles can guide treatment strategies for hazardous chemical exposures.
- The most basic treatment objective is to limit exposure time and decrease concentration as rapidly as possible. Moving rapidly away from a vapor cloud in an accidental release is common sense and illustrates the point of decreasing concentration and duration of exposure. Similarly, deluging with water after splashing a concentrated sulfuric acid on the skin will decrease the chemical's concentration and the duration of exposure.
START/JumpSTART Algorithm (Simple Triage and Rapid Treatment) for Mass Casualty Events
START was developed by the Newport Beach Fire and Marine Department and Hoag Hospital in Newport Beach, California in 1983.
Initially it used the ability to obey commands, respiratory rate, and capillary refill to assign triage category.
Modifications to START in 1996 by Benson et. al. substituted radial pulse for capillary refill, with a report of improved accuracy, especially in cold temperature.
JumpSTART, a pediatric version of START, was developed at the Miami, Florida Children's Hospital in 1995 by Dr. Lou Romig.
Cefipx v3 10. A modification was published in 2001. Formal scientific review of the efficacy of JumpStart has been limited.
JumpSTART is probably the most commonly used pediatric mass casualty triage algorithm in the US.
SALT Mass Casualty Triage Algorithm
SALT stands for 'Sort - Assess - Life Saving Interventions - Treatment and/or Transport'
It was developed as a national all-hazards mass casualty initial triage standard for all patients.
Agencies can easily incorporate SALT into their current Mass Casualty Incident (MCI) triage protocol through simple modification.
References
Proof That 1 Equals 0
- Kirk MA, Deaton ML. Bringing order out of chaos: effective strategies for medical response to mass chemical exposure. Emerg Med Clin North Am. 2007 May;25(2):527-48. [PubMed Citation]
- Triage of Chemical Casualties, Medical Aspects of Chemical Warfare, Chapter 15 (PDF - 285 KB) (U.S. Army, 2008)
- Subbarao I, Johnson C, Bond WF, Schwid HA, Wasser TE, Deye GA, Burkhart KK. Symptom-based, algorithmic approach for handling the initial encounter with victims of a potential terrorist attack. Prehosp Disaster Med. 2005 Sep-Oct;20(5):301-8. [PubMed Citation]
- Cone DC, Koenig KL. Mass casualty triage in the chemical, biological, radiological, or nuclear environment. Eur J Emerg Med. 2005 Dec;12(6):287-302. [PubMed Citation]
- Cone DC, MacMillan DS, Parwani V, Van Gelder C. Pilot test of a proposed chemical/biological/radiation/ nuclear-capable mass casualty triage system. Prehosp Emerg Care. 2008 Apr-Jun;12(2):236-40. [PubMed Citation]
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