Triage
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Triage Methods and Algorithms in Emergency Situations
Overview of Triage Systems
There are two primary forms of triage used in emergency situations:
- Triage Sieve: A primary triage system
- Triage SALT: A secondary triage system
Implementing Primary Triage
At the scene of an incident, initial triage is typically conducted using the Triage Sieve method until casualties can be moved to a casualty-clearing point or station.
Standardized Algorithm
There exists a standardized algorithm for primary triage, which may need to be adapted based on specific circumstances:
- Casualty Assessment Criteria:
- Are casualties able to walk? If yes, they are priority three.
- Is there catastrophic haemorrhage (pumping or splurting blood)? If so, apply a tourniquet; casualty becomes priority one (P1).
- Is the casualty breathing?
- If not breathing and in a major incident scenario, they are considered deceased.
- If breathing but unconscious, move to recovery position; becomes P1.
- Assess respiratory rate (below 10 or above 30 is abnormal, P1).
- Assess pulse rate (over 120 is abnormal, P1).
Utilizing the Triage Algorithm
The triage algorithm is a national standard for all ambulance services in the UK, ensuring a systematic approach:
- Follow the algorithm step-by-step to determine casualty priority.
- Each casualty should ideally be assessed within 90 seconds during primary triage, including essential interventions like tourniquet application.
Challenges in Triage
Challenges may arise when casualties are entrapped or inaccessible:
- If unable to access casualties, alternative methods such as thermal imaging from fire services may be used to confirm casualties.
- Adapt triage methods as necessary despite national standards to suit the specific scenario.
Managing Moving Casualties
Efficiently manage casualties who can walk to clear the scene:
- Direct walking casualties away promptly to focus on higher-priority patients.
- Corral and treat mobile casualties to streamline operations.
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