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What Is Emergency Triage?

Meghan Perry
Meghan Perry

Emergency triage is a medical system used after large-scale catastrophes or in hospital emergency departments to determine which victims or patients most need immediate medical care. This determination is usually made according to severity of injury. Procedures vary slightly depending on whether triage takes place for a catastrophic event or an emergency department, but the basic goal is the same: prioritize victims or patients as quickly as possible in order to reduce the number of casualties. In a major event, such as a hurricane, emergency triage is sometimes set up at the site of the event rather than a hospital.

The emergency triage system started in France in the late 1700s. It was created to quickly respond to the sometimes massive number of injuries and deaths that occurred as a result of war. With doctors, nurses, and emergency personnel working together at the site of the battle to assess injuries, the most severely-injured victims often had a better chance of survival because they received immediate treatment.

The triage system is used to determine which patients require immediate medical care, and which patients can wait.
The triage system is used to determine which patients require immediate medical care, and which patients can wait.

Over the years, emergency triage in the field, such as at a disaster site, has evolved so that particular procedures and assessments are in place to inform prioritization. For example, one of the common triage systems in the U.S. is Simple Triage and Rapid Treatment (START). This system ranks victims based on the urgency of their injuries, or how life-threatening they are.

Emergency triage personnel help people injured during a natural disaster.
Emergency triage personnel help people injured during a natural disaster.

Responders who work in emergency triage in the field are generally taught to assess victims in less than one minute. Factors that come into play include whether or not the victim is breathing and whether or not the victim is responsive. Based on the responders' assessment, the victim is placed into one of four color-coded categories. For example, the least severely injured are placed in the green category, and the most severely injured are placed in the red category. Victims in the latter category require immediate medical attention, as their condition is considered life-threatening. They are therefore treated before victims ranked in other categories.

Ambulance personnel work as part of an emergency triage team.
Ambulance personnel work as part of an emergency triage team.

Color-coded tags not only help the responders to recognize the severity of victims’ injuries, but they also help ensure that each victim is transported to the appropriate treatment facility. Yellow tags indicate injury severity in between red and green — medical attention is required quickly, but the priority is not quite as high as those with red tags. If victims are not breathing, emergency responders will try briefly to clear an airway, but if that does not work, some patients will be placed in the black category, which means they are not expected to survive.

A patient who needs rescue breathing or CPR should be treated before someone with a broken arm.
A patient who needs rescue breathing or CPR should be treated before someone with a broken arm.

Emergency triage is also done in emergency medical facilities, and may not necessarily relate to a catastrophic event. Instead, it provides the sickest patients the highest priority of treatment. Sometimes, the assessment method used in emergency departments is more in-depth, as the level of urgency is not always as high as that following a disaster in which many people are killed or injured at the same time.

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    • The triage system is used to determine which patients require immediate medical care, and which patients can wait.
      By: Tyler Olson
      The triage system is used to determine which patients require immediate medical care, and which patients can wait.
    • Emergency triage personnel help people injured during a natural disaster.
      By: Leonard Zhukovsky
      Emergency triage personnel help people injured during a natural disaster.
    • Ambulance personnel work as part of an emergency triage team.
      By: storm
      Ambulance personnel work as part of an emergency triage team.
    • A patient who needs rescue breathing or CPR should be treated before someone with a broken arm.
      By: Monkey Business
      A patient who needs rescue breathing or CPR should be treated before someone with a broken arm.