Triage is a method used in emergency medicine to sort critically sick or injured patients from those who can wait longer to receive medical treatment. Triage is often used by emergency medical services, by emergency departments and in military battlefield and disaster situations, where multiple ailing patients can be present at once. Though all triage involves rapid patient assessment and determination of medical need, various methods can be used for different situations.
Primary Triage
Emergency medical technicians and hospitals use primary triage to assess individual sick or injured patients to determine how quickly medical care is needed. Emergency departments use primary triage to assess each patient who presents for care. This helps determine who needs immediate treatment, while also managing medical resources, such as surgery or radiology, for patients who need it first. Additionally, emergency medical technicians and paramedics use primary triage to help determine the urgency of a patient's condition in the field, as well as what additional medical resources may be needed to provide care.
Secondary Triage
Secondary triage is a process of re-evaluating a patient who has undergone primary triage. This typically occurs when a patient is brought to a hospital after being evaluated by emergency medical personnel in the field. A physician may re-triage a patient and reassign medical priority. Additionally, patients involved in mass casualty incidents in which multiple people were injured, such as a bus accident, will receive secondary triage by medical personnel before or during transport to a hospital.
S.T.A.R.T Triage
Simple Triage and Rapid Treatment (S.T.A.R.T) is a triage system used by emergency medical technicians during mass casualty incidents involving multiple patients. This triage method allows medical personnel to assess a patient in 30 seconds or less by checking the quality of respirations, perfusion and mental status (RPM). These three assessments help indicate how critical a patient is based on how the respiratory, circulatory and neurological systems are functioning. Once assessed, patients are prioritized based on medical need and likelihood of survival, and are given a color-coded tag that represents medical urgency. Black tags are given for the deceased, red tags for patients needing immediate attention, yellow tags for patients who can withstand delayed care and green tags for patients with minor injuries. Once color tags have been assigned, basic life-saving care is provided for patients with red, yellow and green tags. During S.T.A.R.T triage, patients are given secondary triage assessments while waiting for transport and can be reassigned color tags if urgency status changes.
