Triage

During disasters, triage decisions are made to determine who gets immediate care, who can wait, and (at times) who may not receive care at all. Triage requires rapid decision making based on very limited information. 

Listen to this episode of Ready. Prep. Go! Podcast with Dr. Christina Hernon as she discusses the injuries she encountered and difficult decisions she had to make when she worked the medical tent on the day of the Boston marathon bombing.

Triage derives from a French word meaning “to sort or separate out.”

Triage is dynamic and can happen in multiple settings including the pre-hospital, emergency department, and hospital setting. The same patient may be triaged multiple times as their status may change over time.

 
The purpose of triage is: 
Do the greatest good for the greatest number of people.
 
The goal of triage is: 
Save the most lives.
 
Triage Systems

There are many triage systems that exist. Some triage systems are designed for children. The triage process is NOT perfect. There is no evidence that any particular triage system for children performs better than another.

Here are some of the most popular triage systems for pediatric patients in the United States:

  • JumpSTART
  • SALT: Sort, Assess, Life-Saving Intervention, Treatment/Transport
 
It is important for you to be familiar with the triage system used in your local jurisdiction.
 
Components of Triage Systems

Although there are multiple triage systems, many triage systems include similar components. 

  1. Rapid assessment of breathing, circulation, and mental status.
    • Breathing: Are they breathing? Are they not? If they are breathing, how fast?
    • Circulation: Is there a pulse or not? What is the capillary refill time?
    • Mental status: Are they alert? Do they respond to voice or pain? Are they unresponsive (Often assessed using AVPU: Awake, Verbal, Pain, Unresponsive)
  2. Color-coded triage categories

    Patients are triaged into categories to help determine how patients should be prioritized.

Traffic light graphic used to represent triage categories: Red (Immediate), Yellow (Delayed), Green (Minor/Minimal), and Gray

 

  1. Time-limited interventions

    Simple, quick actions that can make a difference without using many resources:

        • repositioning the airway

        • providing a few rescue breaths

        • decompression of the chest

        • application of tourniquet to control bleeding

        • administering an antidote via autoinjector.

 

Any intervention in triage should not require a large number of people or extensive time.

 

Triage decisions are hard to make. Take a moment to practice. Check out this case-based triage game.

Written by Dennis Ren

Last updated: 5/30/2025

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