Triage Principles

Triage Principles

• Mettag: RED – Priority I – Immediate attention. Identifier is a Mettag torn to the red stripe or Roman numeral I placed on the forehead or back of left hand. First priority casualties are those that have life-threatening injuries that are readily correctable. For purposes of priority for dispatch to the hospital, however, a second sorting or review may be necessary so only those “transportable” cases are taken early. Some will require extensive stabilization at the scene before transport may be safely undertaken. A red tag may be used as an additional means of identification.
• Mettag: YELLOW – Priority II –Delayed attention. Identifier is the Mettag torn to the yellow stripe or Roman numeral II placed on the forehead or back of left hand. Delayed category casualties are all those whose therapy may be delayed without significant threat of life or limb and those for whom extensive or highly sophisticated procedures are necessary to sustain life.
• Mettag: GREEN – Minor injuries. Casualties with minor injuries will receive minimum first aid treatment. They will not be transported to hospitals until all Priority I and II patients have received care. They will be sent from the triage area to a designated area away from the disaster scene in order to reduce confusion. If they are capable, they may also be used as litter bearers or first aid providers.
• Mettag: BLACK – Dead. Identifier is the Mettag torn up to the black stripe or an X on the forehead and covered with a sheet, blanket or other opaque material as soon as possible. Unless absolutely necessary, they should be left in place until released by the coroner. The temporary morgue should be an area away from the scene of the triage area.
• Persons who are psychologically disturbed, who interfere with casualty handling, should be isolated from the incident scene as quickly as possible. Campus Police will be requested to escort individuals to a designated area away from the disaster scene.

Triage Category Guidelines

For multiple casualty incidents involving up to 80 victims:

RED: IMMEDIATE (Priority I)

1. Asphyxia
2. Respiratory obstruction from mechanical causes
3. Sucking cheat wounds
4. Tension pneumothorax
5. Maxillofacial wounds in which asphyxia exists or is likely to develop
6. Shock caused by major external hemorrhage
7. Major internal hemorrhage
8. Visceral injuries or evisceration
9. Cardio/pericardial injuries
10. Massive muscle damage
11. Severe burns over 25%
12. Dislocations
13. Major fracture
14. Major medical problems readily correctable
15. Closed cerebral injuries with increasing loss of consciousness

Simple Treatment and Rapid Treatment (START): Quick identifiers for Red

• Ventilation > 30/min
• Perfusion <>
• Mental status: unable to follow simple directions

YELLOW: DELAYED (Priority II)

1. Vascular injuries requiring repair
2. Wounds of the genitourinary tract
3. Thoracic wounds without asphyxia
4. Severe burns under 25%
5. Spinal cord injuries requiring decompression
6. Suspected spinal cord injuries without neurological signs
7. Lesser fractures
8. Injuries of the eye
9. Maxillofacial injuries without asphyxia
10. Minor medical problems
11. Victims with little hope of survival under the best of circumstances of medical care

For multiple casualty incidents with an overwhelming number of survivors or over 80 victims:

RED: IMMEDIATE (Priority I)

1. Asphyxia
2. Respiratory obstruction from mechanical causes
3. Sucking cheat wounds
4. Tension pneumothorax
5. Maxillofacial wounds in which asphyxia exists or is likely to develop
6. Shock caused by major external hemorrhage
7. Dislocations
8. Severe burns under 25%*
9. Lesser fractures*
10. Major medical problems that can be handled readily

YELLOW: DELAYED (Priority II)

1. Major fractures (if able to stabilize)*
2. Visceral injuries or evisceration*
3. Cardio/pericardial injuries*
4. Massive muscle damage*
5. Severe burns over 25%*
6. Vascular injuries requiring repair
7. Wounds of genitourinary tract
8. Thoracic wounds without asphyxia
9. Closed cerebral injuries with increasing loss of consciousness*
10. Spinal cord injuries requiring decompression
11. Suspected spinal cord injuries without neurological signs
12. Injuries of the eye
13. Maxillofacial injuries without asphyxia
14. Complicated major medical problems*
15. Minor medical problems
16. Victims with little hope of survival under the best of circumstances of medical care

 Legend=  * Conditions which have changed categories