Triage: Maximizing Care With Limited Resources

Triage is an old French term that was first used to refer to the sorting and treatment of those injured in battle. Today, the term is used in situations where there are more casualties than there are rescuers. It is a method that involves assessing quickly, then assisting those casualties that truly need help, but at the same time not wasting resources on casualties who have very, if any, chance of being saved.

Simple Triage and Rapid Treatment (START)

This involves quickly assessing and prioritizing casualties into three categories: immediate, delayed, and dead/non-salvageable.

First, all casualties that can walk need to be moved away from the immediate area so rescuers can deal with the critically injured. The casualties that walk away should still be looked at by rescuers that arrive later.

Immediate Care

This designation is for casualties that need immediate care to have their airway cleared to enable breathing to continue.

Delayed Care

This group includes casualties that are breathing, have a pulse, but can't move on their own e.g. because of a broken leg.

Dead/Non-Salvageable

These are the casualties that are found not breathing and who fail to breath after attempts are made to open and clear the airway. It also includes obviously mortal injuries such as decapitation. Never begin CPR on such a casualty because once you begin you can't stop. As a result you can not continue to triage and other casualties may die that otherwise may have been saved.

As casualties are assessed they are generally marked with ribbons e.g. around the wrists to indicate their classification to others. The colors used are:

• Immediate: Red
• Delayed: Yellow or Green
• Dead: Black or Gray