(K111) A Review of On-Scene Disaster Triage Schemes and Proposal for a Standardized Triage System

Abstract

Introduction:Mass-casualty triage is a critical skill. The are any systems exist to guide providers in making triage decisions, however, there is little scientific literature to validate current systems. There are no internationally agreed upon categories or color. The lack of standardization in triage can lead to confusion.Methods:An expert panel reviewed existing triage systems. Each member was assigned a triage system and asked to conduct an exhaustive literature review and Internet search and to develop a report to the panel. Each system had two or more members assigned to conduct a review.Results:The committee identified nine existing mass casualty triage systems, including two pediatric-specific systems. The systems were noted to be similar in naming and color representations, but differed on the inclusion of an expectant category. Studies that compared the various mass casualty triage systems and found that the ability to obey commands and systolic blood pressure were the best predictors were identified.Conclusions:The committee concluded that no one system could be embraced as a validated system. The committee decided to use the best available scientific information and consensus opinion to develop a system that could serve as a proposed national guideline. The group discussed each component until consensus was reached. The guideline incorporates pieces of most existing triage systems; it was given the name SALT Triage (sort, assess, lifesaving interventions, and treatment and/or transport). This guideline is intended for use on-scene in all-hazards events for both adults and children.