How Triage Works

Types of Triage Situations

Most of us will only experience standard doctor's office or emergency room triage, but the process does adapt to suit a range of other scenarios. As you already know, triage was originally developed for use on battlefields. Tactical Combat Casualty Care methodology uses two major indicators (pulse and mental status determined by a score on the Glasgow Coma Scale) to assign a field triage score (FTS) to help physicians decide which soldiers to treat, and when. Basically, a weak or absent pulse and greatly altered mental state are both predictive of whether or not a person can survive injury, whether they receive immediate care, or not. It might sound harsh, but a 2010 study found that these basic assessments are effective at estimating casualties and helping to assign limited resources to people who can benefit from treatment [source: Eastridge, BJ et al.]. This military-inspired methodology also is used in other emergency triage situations, particularly disasters or other mass casualty events.

Triage in the event of an explosion, major accident or other disaster situation is greatly abbreviated from what patients experience in the doctor's office, and is done by any medical professional working the site. "You have to get them done quickly," says Dr. Batchelor. "Look at the patient, assess them briefly and determine if something needs to be done up front, or can wait a bit." This rapid-fire process is usually accompanied by the use of colored tags and numbers written on the patient to make them easier to spot and assist accordingly.

Trauma triage occurs in a disaster scenario or at the site of a smaller accident, and is typically done several times to keep tabs on the patients' evolving state (when help arrives, before transport to the hospital and upon arrival at the hospital). Several major body functions and other factors are evaluated quickly to assess and classify each patient according to severity. For instance, let's say the doctor examines the patient. Is he breathing? (If the answer is "no," he might be dead, which means no further treatment – important to determine when resources are limited.) If the answer is "yes," what is the respiratory rate? And then, what is the pulse rate? Depending on the answers, the patient might be assigned for immediate treatment; for intervention between the next two to four hours; or perhaps for delayed care [source: Tidy].

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