Triage

Triage (/ˈtriːɑːʒ, triˈɑːʒ/) is the process of determining the priority of patients' treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately; influencing the order and priority of emergency treatment, emergency transport, or transport destination for the patient. Triage (/ˈtriːɑːʒ, triˈɑːʒ/) is the process of determining the priority of patients' treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately; influencing the order and priority of emergency treatment, emergency transport, or transport destination for the patient. This article covers the various types of triage systems as it occurs in medical emergencies, including the prehospital setting, disasters, and emergency department treatment, along with their limitations and ethical considerations. The term comes from the French verb trier, meaning to separate, sort, sift or select. Modern medical triage was invented by Dominique Jean Larrey, a surgeon during the Napoleonic Wars, who 'treat the wounded according to the observed gravity of their injuries and the urgency for medical care, regardless of their rank or nationality', though the general concept of prioritizing by prognosis is foreshadowed in a 17th-century BC Egyptian document. Triage was used further during World War I by French doctors treating the battlefield wounded at the aid stations behind the front. Those responsible for the removal of the wounded from a battlefield or their care afterwards would divide the victims into three categories: For many emergency medical services (EMS) systems, a similar model may sometimes still be applied. In the earliest stages of an incident, such as when one or two paramedics exist to twenty or more patients, practicality demands that the above, more 'primitive' model will be used. However, once a full response has occurred and many hands are available, paramedics will usually use the model included in their service policy and standing orders. As medical technology has advanced, so have modern approaches to triage, which are increasingly based on scientific models. The categorizations of the victims are frequently the result of triage scores based on specific physiological assessment findings. Some models, such as the START model may be algorithm-based. As triage concepts become more sophisticated, triage guidance is also evolving into both software and hardware decision support products for use by caregivers in both hospitals and the field. This section is for concepts in triage. See other sections for specific triage tools, methods, and systems Simple triage is usually used in a scene of an accident or 'mass-casualty incident' (MCI), in order to sort patients into those who need critical attention and immediate transport to the hospital and those with less serious injuries. This step can be started before transportation becomes available. Upon completion of the initial assessment by physicians, nurses or paramedical personnel, each patient may be labelled which may identify the patient, display assessment findings, and identify the priority of the patient's need for medical treatment and transport from the emergency scene. At its most primitive, patients may be simply marked with coloured flagging tape or with marker pens. Pre-printed cards for this purpose are known as a triage tags.