1.Immediate care: the victim has life-threatening injuries but can
be saved. Airway or breathing difficulties (not breathing or breathing rate faster than 30 per minute) Weak or no pulse Uncontrolled or severe bleeding Unresponsive or unconscious 2.Urgent care: victims not fitting into the immediate or delayed categories. Care and transportation can be delayed up to one hour. 3.Delayed care: victims with minor injuries. Care and transportation can be delayed up to three hours. 4.Dead: victims are obviously dead, mortally wounded, or unlikely to survive because of the extent of their injuries, age, and medical condition. Do not become involved in treating the victims at this point, but ask knowledgeable bystanders to care for immediate life-threatening problems (i.e., rescue breathing, bleeding control). START: Step 1 Triage officer announces that all patients that can walk should get up and walk to a designated area for eventual secondary triage. All ambulatory patients are initially tagged as Green. START: Step 2 1. Triage officer assesses patients in the order in which they are encountered 2. Assess for presence or absence of spontaneous respirations 3. If breathing, move to Step 3 4. If apneic, open airway 5. If patient remains apneic, tag as Black 6. If patient starts breathing, tag as Red START: Step 3 1. Assess respiratory rate 2. If ≤30, proceed to Step 4 3. If > 30, tag patient as Red START: Step 4 1. Assess capillary refill 2. If ≤ 2 seconds, move to Step 5 3. If > 2 seconds, tag as Red START: Step 5 1. Assess mental status 2. If able to obey commands, tag as Yellow 3. If unable to obey commands, tag as Red Triage Considerations There are three types of triage: • Primary. Performed at the first encounter with the patient. May be done by EMS, first responders, or hospital staff. • Secondary. Reevaluation of primary triage after additional assessment and/or interventions. Often used at the hospital to prioritize patients for operative care or advanced studies, but should be conducted on the scene, if transport is delayed. • Tertiary. Performed during ongoing definitive care.
• Patients may arrive on foot or via non-EMS transport
and require primary triage at the hospital. What is ABCDE in triage? “ABCDE” stands for Airway, Breathing, Circulation, Disability, and Exposure. First, life-threatening airway problems are assessed and treated; second, life-threatening breathing problems are assessed and treated; and so on. Using this structured approach, the aim is to quickly identify life- threatening problems and institute treatment to correct them. Often, assistance will be required from emergency medical services, a specialist, or a hospital response team (e.g., medical emergency team or cardiac arrest team). The ABCDE approach helps to rapidly recognize the need for assistance. Responders should call for help as soon as possible and exploit the resources of all persons present to increase the speed of both assessment and treatment. Improved outcome is most often based on a team effort. • The triage colors may be assigned by giving triage tags to patients or simply by physically sorting patients into different designated areas. (see the algorithm below) "Green" patients are assigned by asking all victims who can walk to a designated area. All non- ambulatory patients are then assessed. Black tags are assigned to victims who are not breathing even after attempts to open the airway. Red tags are assigned to any victim with the following: • Respiratory rate greater than 30 • Absent radial pulse or cap refill greater than 2 sec • Unable to follow simple commands