Triage in Mass Casualty Situations

Author: Rebecca Mersh, James Vassallo / Editor: Rob James, Lauren Fraser / Codes:  / Published: 06/01/2020

This session covers the importance of, and methods of performing triage in mass casualty situations, in keeping with curriculum item ‘Know how to triage multiple casualties’ in HAP26 – Pre-Hospital Care.

Learning Objectives

After this session it is anticipated that users will be able to:

• Describe what a MCI is

• Understand the importance of triage in a MCI

• Explain how to effectively triage casualties in these scenarios

• Know what tools are available to assist in this process, in both adult and paediatric populations

• Be aware of some pitfalls related to triage in MCIs

References

1. Greaves, I. and Porter, K. (2010). Oxford handbook of pre-hospital care. 3rd ed. Oxford: Oxford University Press, p.602. (Greaves and Porter, 2010)
2. RCEM guidelines. (2017). Initial Assessment of Emergency Department Patients. [online] Available here. [Accessed 30 Jul 2019].
3. Marx, John A. Marx. (2014). Rosen’s Emergency Medicine: Concepts and clinical practice. 8th ed. Philadelphia, PA: Elsevier/Saunders.
4. World Medical Association. (2010). Statement on medical ethics in the event of disasters. [online] Available here. [Accessed 7 Jul 2019].
5. Sanders, M. and McKenna, K. (2011). Mosbys Paramedic Textbook. Burlington, MA: Jones & Bartlett Publishers. 
6. Vassallo, J., Smith, JE., and Wallis LA. (2018). Major incident triage and the implementation of a new triage tool, the MPTT-24. Journal of the Royal Army Medical Corps, 164(1), pp.103-106.
7. NHS England. (2019). Clinical Guidelines for Major Incidents and Mass Casualty Events. [online] Available here. [Accessed 30 Jul 2019].
8. Lowes A. and Cosgrave J. (2016). Prehospital organization and management of a mass casualty incident. BJA Education.  [online] Available here. [Accessed 30 Jul 2019].
9. Vassallo J. and Smith J. (2019). Major incident triage and the evaluation of the Triage Sort as a secondary triage method. Emergency Medicine Journal, 36(1), pp.281-286.
10. Lyle, K., Thompson, T. and Graham, J. (2009). Pediatric Mass Casualty: Triage and Planning for the Prehospital Provider. Clinical Pediatric Emergency Medicine, 10(3), pp.173-185.
11. CHEMM. (2011). JumpSTART Pediatric Triage Algorithm. [online] Available here. [Accessed 27 Jul 2019].
12. Sanddal, T., Loyacono, T. and Sanddal, N. (2004). Effect of JumpSTART Training on Immediate and Short-term Pediatric Triage Performance. Pediatric Emergency Care, 2(11), pp.749-753.
13. Wallis, L. (2006). Comparison of paediatric major incident primary triage tools. Emergency Medicine Journal, 23(6), pp.475-478. 14. Assistant secretary for preparedness and response. (2019). Mass Casualty Trauma Triage: Paradigms and Pitfalls. [online] Available here. [Accessed 2 Aug 2019]