It is the process to sort out the individual from mass casualty according to their need of urgency.

1. TRIAGE PROTOCOL
BY Ms. AMBIKA BAGORA

2. Definition of Triage-
“Triage is the term derived from French verb
trier meaning to sort or to choose.”

3. It is the process by which patients classified
according to the type and urgency of thier
conditions to gets the Right patient to the
Right place at the Right time with the
Right care provider.

4.  Identifying the patient.
 Identifying the priority of the patient’s need
for medical treatment and transport from the
emergency scene.
 Track the patient’s progress through the triage
process.
 Identify additional hazards such as
contamination.

5. 1. Simple triage
1. Advanced triage
1. Continuous integrated triage
1. Reverse triage
1. Under triage or over triage

6. 1. Simple triage- It 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 hospital and
those with less serious injuries.

7. 2. Advance triage- In advance triage, doctors
and specially trained nurses may decide that
some seriously injured people should not
receive advanced care because they are
unlikely to survive, in order to increase the
chances for others with higher likelihood.

8. 3. Continous integrated triage- It is an
approach to triage in mass casualty. It
combines three form of triage with progressive
specificity to most rapidly identify those
patients in greatest need of care while
balancing the needs of the individual patients
against the available resources. Continous
integrated triage employs-
a. Group triage
b. Individual triage
c. Hospital triage

9. 4. Reverse triage- This process of triage can
be applied to discharging patients early
when the medical system is stressed.
• During a “surge” in demand, such as
immediate after a natural disaster, many
hospital beds will be occupied by regular
non-critical patients.
• In order to accommodate a greater
number of the new critical patients, the
existing patients may be triaged, and
those who will not need immediate care
can be discharged.

10. 5. Under triage- It is the under estimating the
severity of an illness or injury. An example of
this would be categorizing as-
* Priority 1 (immediate)
* Priority 2 (delayed)
* Priority 3 (minimal)
6. Over triage- It is over estimating of the
severity of illness or injury. An example of this
would be categorizing as-
* Priority 1 (minimal)
* Priority 2 (delayed)
* Priority 3 (minimal)

11. 1. RED (Resuscitation)- Threat to life
 Time of assessment immediate
 Characteristics-
- Obstructed airway
- SpO2 < 80
- Respiratory rate >35 or < 3
- Heart rate > 130
- BPSYS < 80
- GCS < 8

12. Example-
 Cardiac and respiratory arrest
 Major trauma
 Active seizure
 Shock
 Status asthmatics

14. 2. Orange (Emergent)- Potential threat to life.
 Characteristics-
- Threatened airway
- SpO2 : 80-89
- RR : 31-35
- HR : >40
- BPsys : 80-89
- GCS : 9-12
- Tp : > 40 , < 32

15.  Example-
 Decreased level of consciousness.
 Severe respiratory distress.
 Chest pain with cardiac suspicion.
 Severe abdominal pain.
 G.I. Bleeding with abnormal vital signs.
 Chemical exposure to eye.

16. 3. Yellow (less urgent)- Condition with significant
distress.
 Characteristics-
- SpO2 : 90-94
- RR : 26-30
- HR : 111-120, 40-49
- GCS : 14
- Tp : 38.1-40, 32-34

17. Example-
 Head injury without decrease of LOC but with
vomiting.
 Mild to moderate respiratory distress.
 G.I. Bleed not actively bleed.
 Acute psycosis.
 Chest pain.

18. 4. Green (Not urgent)-
 Condition can be delayed, no distress.
 Like- Minor trauma, Depression with no
suicidal attempts.
 Sore throat with temp. < 39.

21.  Extensive knowledge to emergency
medical treatment.
 Adequate training and competent skills,
language, terminology.
 Ability to use the critical thinking
process.
 Good thinking maker.

22.  Identifying the casualties.
 Maintain privacy and confidentiality.
 Visualize all incoming patients even
while interviewing others.
 Maintain good communication between
triage and treatment area.

23.  Maintain good communication with
waiting area.
 Use all resources to maintain high
standard of care.
 Teaching ______ use of thermometer,
first aid??? But avoid lecturing.

24. Good, better, best. Never let it rest. Till
your good is better and your better is
best.