DISASTER TRIAGE NURSING

TRIAGE
The sorting of and allocation of treatment to patients and especially battle
and disaster victims according to a system of priorities designed to maximize
the number of survivors.
DISASTER TRIAGE
COLORS
RED TAG: IMMEDIATE
·Seen 1st
·Injuries are life-threatening but
they could possibly survive if they
are immediately treated.
·Severe alteration in breathing,
circulation, and neuro/mental
status
YELLOW TAG: DELAYED
·Seen 2nd (second priority)
·Significant injuries BUT at
this point their breathing,
circulation, and mental status
is within normal range but this
could change.
GREEN TAG: MINOR
·"Walking wounded".
·Treatment can be delayed for
several hours, and some can
treat themselves.
·Breathing, circulation, mental
status not expected to change
BLACK TAG: EXPECTANT
·Wounded is dying or expired.
·Injuries are deadly to the
point the individual will not
survive.
·Absence of breathing,
circulation, mental status.
RED TAG: IMMEDIATE
1. Asphyxia
2. Respiratory obstruction from mechanical causes
3. Sucking chest 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
RED TAG: IMMEDIATE
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
YELLOW TAG: DELAYED
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
YELLOW TAG: DELAYED
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.
TYPES TRIAGE

• Primary Triage
• Secondary Triage
• Third triage
PRIMARY TRIAGE SYSTEM
START ADULT TRIAGE
PRIMARY TRIAGE SYSTEM
HOMEBUSH TRIAGE STANDARD
PRIMARY
TRIAGE
SYSTEM

SIEVE
PRIMARY
TRIAGE
SYSTEM
CareFlight
PRIMARY
TRIAGE
SYSTEM
Sacco Triage
Method
PRIMARY
TRIAGE
SYSTEM
Military Triage
PRIMARY
TRIAGE
SYSTEM

SALT Triage
PRIMARY TRIAGE
SYSTEM

JumpSTART
Triage
SECONDARY TRIAGE SYSTEM

SAVE Triage
SECONDARY
TRIAGE
SYSTEM

SORT Triage
 THIRD TRIAGE SYSTEM

CRAMS Triage
 THIRD TRIAGE SYSTEM

ESI
TAGGING
Tagging starts with the nearest victim
Immediate treatment such as putting pressure dressing on
active bleeding is done during assessment.
Everyone on the field is rapidly assessed and tagged by
the first triage team
You move on to next victim one by one after each
assessment.
 The general principle of MCI response (as in disaster
situation) is that: the greatest good needs to be offered to
the greatest amount of people.
 Triage on mass casualty
incident differs from hospital
ED’s triage. In the hospital, 2–5
patient arrives and one with
the gravest injury-near death is
saved first.
HOSPITAL TRIAGE VS.
DISASTER TRIAGE: KEY
DIFFERENCES
PURPOSE
• Hospital Triage: Aim to optimize resource
allocation within a healthcare facility, ensuring
patients with the most critical needs receive
care first.
• Disaster Triage: Focuses on maximizing survival in
overwhelming situations with limited resources.
SETTING
• Hospital Triage: Occurs in controlled, well-
equipped environments with access to
diagnostic tools and various specialists.
• Disaster Triage: Often takes place in
chaotic, resource-scarce environments with
limited equipment and personnel.
CRITERIA
• Hospital Triage: Uses standardized systems like ESI
(Emergency Severity Index) that consider
physiological parameters, potential outcomes, and
resource needs.
• Disaster Triage: Employs S.T.A.R.T. (Simple Triage And
Rapid Treatment) or similar systems based on
immediate survival potential.
TREATMENT
• Hospital Triage: Patients receive initial interventions
and diagnostic tests before definitive treatment.
• Disaster Triage: Treatment is minimal and focuses
on stabilizing critical patients for transport or
further care. Focus is on interventions with the
highest impact on survival within limited resources.
Scenario 2: Evacuation after a hurricane
• Setting: Crowded shelter with limited
medical personnel, potential exposure to
floodwaters.
• Patients:
⚬ An elderly woman with worsening
pneumonia, struggling to breathe.
⚬ A young man with a deep
laceration on his arm, risk of
infection.
⚬ A pregnant woman experiencing
early labor contractions.
Scenario 1: Earthquake aftermath triage
• Setting: Collapsed building site, limited
medical supplies, overwhelmed first
responders.
• Patients:
⚬ A young woman with a crush injury
to her leg, conscious but in pain.
⚬ An elderly man unconscious and
bleeding heavily from a head wound.
⚬ A child in shock with minor cuts and
bruises.
Prepared by: XYLA P. AQUINO, RN