Mass casualty incident triage - Revision history

Danbot: Strip excess bold

2026-03-22T09:36:27Z

Strip excess bold

Cole Ettingoff: /* SALT Triage Algorithm */

2025-05-05T22:47:23Z

SALT Triage Algorithm

← Older revision		Revision as of 22:47, 5 May 2025
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	4. ASSIGN TRIAGE CATEGORY		4. ASSIGN TRIAGE CATEGORY
	Dead (Black)		==== Dead (Black) ====

	* No pulse and not breathing after airway repositioning		* No pulse and not breathing after airway repositioning
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	* Obvious signs incompatible with life (e.g., decapitation, massive head trauma)		* Obvious signs incompatible with life (e.g., decapitation, massive head trauma)

			==== Immediate (Red) ====
	Immediate (Red)

	* Cannot follow commands, breathing with a pulse		* Cannot follow commands, breathing with a pulse
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	* Major burns without airway compromise		* Major burns without airway compromise

			==== Delayed (Yellow) ====
	Delayed (Yellow)

	* Can follow commands, has adequate perfusion and respirations		* Can follow commands, has adequate perfusion and respirations
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	* Does not meet immediate criteria, but injuries are still serious		* Does not meet immediate criteria, but injuries are still serious

			==== Minimal (Green) ====
	Minimal (Green)

	* Walking wounded		* Walking wounded
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	* Minor injuries; requires delayed or minimal treatment		* Minor injuries; requires delayed or minimal treatment

			==== Expectant (Gray) ====
	Expectant (Gray)

	* Unlikely to survive given current resources		* Unlikely to survive given current resources

Cole Ettingoff: /* SALT Triage Algorithm */

2025-05-05T22:46:09Z

SALT Triage Algorithm

← Older revision		Revision as of 22:46, 5 May 2025
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	2. ASSESS (Remaining Patients One by One)		2. ASSESS (Remaining Patients One by One)

	3. LIFESAVING INTERVENTIONS		3. LIFESAVING INTERVENTIONS
	Perform only if resources and time allow:		Perform only if resources and time allow:
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	*		*
	* May be reassessed if resource availability improves		* May be reassessed if resource availability improves


	===Special Considerations===		===Special Considerations===

Cole Ettingoff: /* Sort, Assess, Lifesaving intervention, Treatment/Transport (SALT) */

2025-05-05T22:45:35Z

Sort, Assess, Lifesaving intervention, Treatment/Transport (SALT)

← Older revision		Revision as of 22:45, 5 May 2025
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	==Sort, Assess, Lifesaving intervention, Treatment/Transport (SALT)==		==Sort, Assess, Lifesaving intervention, Treatment/Transport (SALT)==

			* Utilitarian focus: Do the greatest good for the greatest number.
			*
			* All-hazards applicable: Works for trauma, medical, and chemical/radiological events.
			*
			* Incorporates bystanders, visible injuries, and movement in triage prioritization.
			*
			* Prioritizes lifesaving interventions only when resources allow.
			*
			===Triage Categories===
			* Immediate (Red) – Life-threatening injury or condition requiring immediate care to survive
			*
			* Delayed (Yellow) – Serious but not immediately life-threatening injuries
			*
			* Minimal (Green) – Walking wounded with minor injuries
			*
			* Expectant (Gray) – Likely to die despite maximal intervention
			*
			* Dead (Black) – No signs of life

			===SALT Triage Algorithm===
			1. SORT
			* Direct all patients: “If you can hear me and can walk, move to [safe location].”
			*
			* Those who walk → Minimal (Green)
			*
			* Assess remaining patients in the order of:
			*
			* Still
			*
			* Waving
			*
			* Walking but unable to relocate

			2. ASSESS (Remaining Patients One by One)
			3. LIFESAVING INTERVENTIONS
			Perform only if resources and time allow:

			* Open airway (consider basic adjuncts)
			*
			* Control major hemorrhage
			*
			* Chest decompression for tension pneumothorax
			*
			* Auto-injector antidotes (e.g., for nerve agents)
			*
			* Use tourniquets or hemostatic dressings as appropriate

			4. ASSIGN TRIAGE CATEGORY
			Dead (Black)

			* No pulse and not breathing after airway repositioning
			*
			* Obvious signs incompatible with life (e.g., decapitation, massive head trauma)


			Immediate (Red)

			* Cannot follow commands, breathing with a pulse
			*
			* Respiratory distress, uncontrolled bleeding, or signs of shock
			*
			* Major burns without airway compromise


			Delayed (Yellow)

			* Can follow commands, has adequate perfusion and respirations
			*
			* Does not meet immediate criteria, but injuries are still serious


			Minimal (Green)

			* Walking wounded
			*
			* Minor injuries; requires delayed or minimal treatment


			Expectant (Gray)

			* Unlikely to survive given current resources
			*
			* Still have signs of life; provide comfort measures when possible
			*
			* May be reassessed if resource availability improves


			===Special Considerations===
			* Re-triage regularly as the situation evolves
			*
			* SALT is designed for field use by trained personnel
			*
			* Consider special tags, tape, or digital tracking to clearly mark patients
			*
			* Clear communication with incident command and receiving facilities is essential

			===Advantages of SALT over START/JumpSTART===
			* Applicable across all ages and incident types
			*
			* Includes expectant category (not present in START)
			*
			* Emphasizes lifesaving interventions in line with resources
			*
			* Fully meets MUCC national guidelines

	==Simple Triage and Rapid Treatment (START)==		==Simple Triage and Rapid Treatment (START)==

Cole Ettingoff: /* ClassificationsLerner EB, Schwartz RB, Coule PL, et al. "Mass Casualty Triage: An Evaluation of the Data and Development of a Proposed National Guideline." Disaster Medicine and Public Health Preparedness 2(Suppl. 1) 2008, pp S25-S34. */

2025-05-05T18:56:33Z

ClassificationsLerner EB, Schwartz RB, Coule PL, et al. "Mass Casualty Triage: An Evaluation of the Data and Development of a Proposed National Guideline." Disaster Medicine and Public Health Preparedness 2(Suppl. 1) 2008, pp S25-S34.

← Older revision		Revision as of 18:56, 5 May 2025
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	==Classifications<ref name="lerner">Lerner EB, Schwartz RB, Coule PL, et al. "Mass Casualty Triage: An Evaluation of the Data and Development of a Proposed National Guideline." ''Disaster Medicine and Public Health Preparedness'' 2(Suppl. 1) 2008, pp S25-S34.</ref>==		==Classifications<ref name="lerner">Lerner EB, Schwartz RB, Coule PL, et al. "Mass Casualty Triage: An Evaluation of the Data and Development of a Proposed National Guideline." ''Disaster Medicine and Public Health Preparedness'' 2(Suppl. 1) 2008, pp S25-S34.</ref>==
	*Walking wounded~~/minor (green)~~		Minor (Green) – "Walking wounded" with minimal injuries
	*Delayed (~~yellow~~)
	*Immediate (~~red~~)		Delayed (Yellow) – Serious but non-life-threatening injuries
	*Deceased/~~expectant~~ (~~black~~)
			Immediate (Red) – Life-threatening injuries requiring urgent intervention

			Deceased/Expectant (Black) – No signs of life or injuries incompatible with survival, based on current resources

	==Sort, Assess, Lifesaving intervention, Treatment/Transport (SALT)==		==Sort, Assess, Lifesaving intervention, Treatment/Transport (SALT)==

Rossdonaldson1: /* Video */

2024-04-17T20:13:08Z

Video

← Older revision		Revision as of 20:13, 17 April 2024
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	*[[Mass casualty incidents]]		*[[Mass casualty incidents]]
	*[[Combat triage]]		*[[Combat triage]]

	~~==Video==~~
	~~{{#widget:YouTube\|id=m-b9pelsHQE}}~~

	==References==		==References==

Mholtz at 07:04, 23 October 2017

2017-10-23T07:04:12Z

← Older revision		Revision as of 07:04, 23 October 2017
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	==Background==		==Background==
	*Used by first responders to quickly classify victims during a mass casualty incident (MCI) based on the severity of their injury		*Used by first responders to quickly classify victims during a mass casualty incident (MCI) based on the severity of their injury
			*Unlike standard medical triage, MCI triage is more utilitarian (i.e. the greatest good for the greatest number of people)
			*Multiple triage systems exist, however evidence regarding their effectiveness is lacking<ref>Culley JM, Svendsen E. A review of the literature on the validity of mass casualty triage systems with a focus on chemical exposures. American journal of disaster medicine. 2014;9(2):137-150. doi:10.5055/ajdm.2014.0150.</ref>
			*In an effort to update and standardize MCI triage, the Model Uniform Core Criteria (MUCC) were created as a national guideline for MCI triage<ref>Model uniform core criteria for mass casualty triage. Disaster Med Public Health Prep. 2011;5(2):125-8.</ref>
			**These criteria have been endorsed by all major national shareholders, including NAEMSP, ACEP, ACS, NAEMT, NASEMSO, AMA, CDC, and others.
			**Currently, the SALT triage system is the only one that meets the Model Uniform Core Criteria

	==~~Classification~~<ref name="lerner">Lerner EB, Schwartz RB, Coule PL, et al. "Mass Casualty Triage: An Evaluation of the Data and Development of a Proposed National Guideline." ''Disaster Medicine and Public Health Preparedness'' 2(Suppl. 1) 2008, pp S25-S34.</ref>==		==Classifications<ref name="lerner">Lerner EB, Schwartz RB, Coule PL, et al. "Mass Casualty Triage: An Evaluation of the Data and Development of a Proposed National Guideline." ''Disaster Medicine and Public Health Preparedness'' 2(Suppl. 1) 2008, pp S25-S34.</ref>==
	*Walking wounded/minor (green)		*Walking wounded/minor (green)
	*Delayed (yellow)		*Delayed (yellow)
	*Immediate (red)		*Immediate (red)
	*Deceased/expectant (black)		*Deceased/expectant (black)

			==Sort, Assess, Lifesaving intervention, Treatment/Transport (SALT)==


	==Simple Triage and Rapid Treatment (START)==		==Simple Triage and Rapid Treatment (START)==

Mholtz at 19:56, 3 July 2017

2017-07-03T19:56:25Z

← Older revision		Revision as of 19:56, 3 July 2017
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	[[File:Flowchart START.jpg\|thumb\|START triage algorithm]]		[[File:Flowchart START.jpg\|thumb\|START triage algorithm]]
	''Always make sure you are safe. Then speak loudly and ask people to stand up and walk towards you. People who are:''		''Always make sure you are safe. Then speak loudly and ask people to stand up and walk towards you. People who are:''
	*Able to walk relocate to a certain area '''(~~green~~)'''		*Able to walk relocate to a certain area <span style="color:green">'''(minor)'''</span>
	*Non-ambulatory patients are then assessed		*Non-ambulatory patients are then assessed
	**No respirations → re-position airway		**No respirations → re-position airway
	***No respirations '''(deceased/expectant)'''		***No respirations '''(deceased/expectant)'''
	***Respirations '''(immediate)'''		***Respirations <span style="color:red">'''(immediate)'''</span>
	**Yes respirations		**Yes respirations
	***>30/min '''(immediate)'''		***>30/min <span style="color:red">'''(immediate)'''</span>
	***<30 → check perfusion		***<30 → check perfusion
	****Radial pulse absent '''OR''' capillary refill >2 seconds '''(immediate)'''		****Radial pulse absent '''OR''' capillary refill >2 seconds <span style="color:red">'''(immediate)'''</span>
	****Radial pulse present '''OR''' capillary refill <2 seconds → check mental status		****Radial pulse present '''OR''' capillary refill <2 seconds → check mental status
	*****Unable to follow simple commands '''(immediate)'''		*****Unable to follow simple commands <span style="color:red">'''(immediate)'''</span>
	*****Follows simple commands '''(delayed)'''		*****Follows simple commands <span style="color:#eec61f">'''(delayed)'''</span>

	==JumpSTART (Pediatric Patients)==		==JumpSTART (Pediatric Patients)==
	[[File:JumpSTART Triage 3.gif\|thumb\|JumpSTART triage algorithm]]		[[File:JumpSTART Triage 3.gif\|thumb\|JumpSTART triage algorithm]]
	*Able to walk relocate to a certain area '''(~~green~~)'''		*Able to walk relocate to a certain area <span style="color:green">'''(minor)'''</span>
	*Non-ambulatory patients are then assessed		*Non-ambulatory patients are then assessed
	**No respirations → re-position airway		**No respirations → re-position airway
	***Respirations '''(immediate)'''		***Respirations <span style="color:red">'''(immediate)'''</span>
	***No respirations → check pulse		***No respirations → check pulse
	****No pulse '''(deceased/expectant)'''		****No pulse '''(deceased/expectant)'''
	****Yes pulse → 5 rescue breaths		****Yes pulse → 5 rescue breaths
	*****Still no respirations '''(deceased/expectant)'''		*****Still no respirations '''(deceased/expectant)'''
	*****Respirations '''(immediate)'''		*****Respirations <span style="color:red">'''(immediate)'''</span>
	**Yes respirations		**Yes respirations
	***<15 or >45/min '''(immediate)'''		***<15 or >45/min <span style="color:red">'''(immediate)'''</span>
	***15-45/min → check perfusion		***15-45/min → check perfusion
	****Pulse absent or CRT >2 seconds		****Pulse absent or CRT >2 seconds
	*****Control bleeding '''(immediate)'''		*****Control bleeding <span style="color:red">'''(immediate)'''</span>
	****Pulse present or CRT <2 seconds → check mental status		****Pulse present or CRT <2 seconds → check mental status
	*****Inappropriate '''(immediate)'''		*****Inappropriate <span style="color:red">'''(immediate)'''</span>
	*****Appropriate '''(delayed)'''		*****Appropriate <span style="color:#eec61f">'''(delayed)'''</span>

	==Secondary Assessment of Victim Endpoint (SAVE)==		==Secondary Assessment of Victim Endpoint (SAVE)==

Mholtz: Text replacement - "OR" to "'''OR'''"

2017-05-31T02:10:09Z

Text replacement - "OR" to "'''OR'''"

← Older revision		Revision as of 02:10, 31 May 2017
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	***>30/min '''(immediate)'''		***>30/min '''(immediate)'''
	***<30 → check perfusion		***<30 → check perfusion
	****Radial pulse absent OR capillary refill >2 seconds '''(immediate)'''		****Radial pulse absent '''OR''' capillary refill >2 seconds '''(immediate)'''
	****Radial pulse present OR capillary refill <2 seconds → check mental status		****Radial pulse present '''OR''' capillary refill <2 seconds → check mental status
	*****Unable to follow simple commands '''(immediate)'''		*****Unable to follow simple commands '''(immediate)'''
	*****Follows simple commands '''(delayed)'''		*****Follows simple commands '''(delayed)'''

Rossdonaldson1: /* Simple Triage and Rapid Treatment (START) */

2017-03-20T18:02:21Z

Simple Triage and Rapid Treatment (START)

← Older revision		Revision as of 18:02, 20 March 2017
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	==Simple Triage and Rapid Treatment (START)==		==Simple Triage and Rapid Treatment (START)==
	[[File:Flowchart START.jpg\|thumb\|START triage algorithm]]		[[File:Flowchart START.jpg\|thumb\|START triage algorithm]]
	*Always make sure you are safe. Then speak loudly and ask people to stand up and walk towards you. People who are:		''Always make sure you are safe. Then speak loudly and ask people to stand up and walk towards you. People who are:''
	*Able to walk relocate to a certain area '''(green)'''		*Able to walk relocate to a certain area '''(green)'''
	*Non-ambulatory patients are then assessed		*Non-ambulatory patients are then assessed

← Older revision		Revision as of 09:36, 22 March 2026
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	[[File:Flowchart START.jpg\|thumb\|START triage algorithm]]		[[File:Flowchart START.jpg\|thumb\|START triage algorithm]]
	''Always make sure you are safe. Then speak loudly and ask people to stand up and walk towards you. People who are:''		''Always make sure you are safe. Then speak loudly and ask people to stand up and walk towards you. People who are:''
	*Able to walk relocate to a certain area <span style="color:green">~~'''~~(minor)~~'''~~</span>		*Able to walk relocate to a certain area <span style="color:green">(minor)</span>
	*Non-ambulatory patients are then assessed		*Non-ambulatory patients are then assessed
	**No respirations → re-position airway		**No respirations → re-position airway
	***No respirations ~~'''~~(deceased/expectant)~~'''~~		***No respirations (deceased/expectant)
	***Respirations <span style="color:red">~~'''~~(immediate)~~'''~~</span>		***Respirations <span style="color:red">(immediate)</span>
	**Yes respirations		**Yes respirations
	***>30/min <span style="color:red">~~'''~~(immediate)~~'''~~</span>		***>30/min <span style="color:red">(immediate)</span>
	***<30 → check perfusion		***<30 → check perfusion
	****Radial pulse absent ~~'''~~OR~~'''~~ capillary refill >2 seconds <span style="color:red">~~'''~~(immediate)~~'''~~</span>		****Radial pulse absent OR capillary refill >2 seconds <span style="color:red">(immediate)</span>
	****Radial pulse present '''OR''' capillary refill <2 seconds → check mental status		****Radial pulse present '''OR''' capillary refill <2 seconds → check mental status
	*****Unable to follow simple commands <span style="color:red">~~'''~~(immediate)~~'''~~</span>		*****Unable to follow simple commands <span style="color:red">(immediate)</span>
	*****Follows simple commands <span style="color:#eec61f">~~'''~~(delayed)~~'''~~</span>		*****Follows simple commands <span style="color:#eec61f">(delayed)</span>

	==JumpSTART (Pediatric Patients)==		==JumpSTART (Pediatric Patients)==
	[[File:JumpSTART Triage 3.gif\|thumb\|JumpSTART triage algorithm]]		[[File:JumpSTART Triage 3.gif\|thumb\|JumpSTART triage algorithm]]
	*Able to walk relocate to a certain area <span style="color:green">~~'''~~(minor)~~'''~~</span>		*Able to walk relocate to a certain area <span style="color:green">(minor)</span>
	*Non-ambulatory patients are then assessed		*Non-ambulatory patients are then assessed
	**No respirations → re-position airway		**No respirations → re-position airway
	***Respirations <span style="color:red">~~'''~~(immediate)~~'''~~</span>		***Respirations <span style="color:red">(immediate)</span>
	***No respirations → check pulse		***No respirations → check pulse
	****No pulse ~~'''~~(deceased/expectant)~~'''~~		****No pulse (deceased/expectant)
	****Yes pulse → 5 rescue breaths		****Yes pulse → 5 rescue breaths
	*****Still no respirations ~~'''~~(deceased/expectant)~~'''~~		*****Still no respirations (deceased/expectant)
	*****Respirations <span style="color:red">~~'''~~(immediate)~~'''~~</span>		*****Respirations <span style="color:red">(immediate)</span>
	**Yes respirations		**Yes respirations
	***<15 or >45/min <span style="color:red">~~'''~~(immediate)~~'''~~</span>		***<15 or >45/min <span style="color:red">(immediate)</span>
	***15-45/min → check perfusion		***15-45/min → check perfusion
	****Pulse absent or CRT >2 seconds		****Pulse absent or CRT >2 seconds
	*****Control bleeding <span style="color:red">~~'''~~(immediate)~~'''~~</span>		*****Control bleeding <span style="color:red">(immediate)</span>
	****Pulse present or CRT <2 seconds → check mental status		****Pulse present or CRT <2 seconds → check mental status
	*****Inappropriate <span style="color:red">~~'''~~(immediate)~~'''~~</span>		*****Inappropriate <span style="color:red">(immediate)</span>
	*****Appropriate <span style="color:#eec61f">~~'''~~(delayed)~~'''~~</span>		*****Appropriate <span style="color:#eec61f">(delayed)</span>

	==Secondary Assessment of Victim Endpoint (SAVE)==		==Secondary Assessment of Victim Endpoint (SAVE)==