Triage is a French word meaning “to sort.” Triage is a process that is used to assign priority for treatment and transport. In the prehospital environment, triage is used in two different contexts:
The goal of patient management at the MCI scene is to do the most good for the most patients with the resources available. It is the responsibility of the prehospital care provider to make decisions about who is to be managed first. The usual rules about saving lives are different in MCIs. The decision is always to save the most lives; however, when the available resources are not sufficient for the needs of all the injured patients present, these resources should be used for the patients who have the best chance of surviving. In a choice between a patient with a catastrophic injury, such as severe brain trauma, and a patient with acute intra-abdominal hemorrhage, the proper course of action in an MCI is to manage first the salvageable patient—the patient with the abdominal hemorrhage. Treating the patient with severe head trauma first will probably result in the loss of both patients; the head trauma patient may die because he or she may not be salvageable, and the abdominal hemorrhage patient may die because time, equipment, and EMS personnel spent managing the unsalvageable patient kept this salvageable patient from receiving the simple care needed to survive until definitive surgical care was available.
The "sorting scheme" most often used divides patients into five categories based on need of care and chance of survival:
Keep scene time as brief as possible (10 minutes or less ideally) when any of the following life-threatening conditions are present:
The likelihood of survival for a patient with traumatic injuries depends on the immediate identification and mitigation of conditions that interfere with tissue perfusion.
|NAEMT, PHTLS Prehospital Trauma Life Support 8th Edition, Burlington, MA: Jones and Bartlett Learning, 2016|