Triage

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Introduction

Triage is the assignment of priority to patients in regards to delivery of health care. It assumes that not every patient will receive immediate attention.

 

It depends on the need of patients, as well as the resources - staff, space, and supplies - that are available. Some patients require immediate care, others may wait, and still others may be so severely injured that in some circumstances, resuscitative efforts may be futile.

 

Triage also describes the assignment of patients in the field to various health care facilities. Prehospital assessment is very important; if a patient has severe trauma, they require as high acuity a centre as available.

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In the case of multiple casualties, it is impotant to identify and treat life-threatening problems first.

With mass casualties, the number and severity of injuries exceeds the capacity of the health care team. In this situation, patients are treated according to the greatest chance of survival and the effectiveness with which resources can be used.

 

In low-resource settings, even two casualties can overwhelm one health care provider and their supplies.

 

In wilderness situations, pre-preparation may not be available. It is critical to thoroughly understand the equipment and supplies available.

 

Mass casualties in the field

The initial step in dealing with mass casualties is to rapidly categorize the patients. Those that can should be instructed to move themselves to a clear area nearby, leaving the more severely injured patients behind. These can then be assessed for life-threatening injury, which are immediately dealt with, followed by limb-threatening injury.

Some patients may not be expected to survive, and should be treated to ensure their comfort.

One triage classification strategy is as such:

• immediate - life-saving intervention required
• delayed - may wait 1-2 hours prior to treatment
• minimal or ambulatory - may wait many hours
• expectant - likely to soon die

Colour coordination for identifying these patients may be helpful.

Triage should be carried out regularly in order to ensure changes in patient conditions are identified and addesssed as necessary.

 

 

Resources and References

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