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Mass Casualty Triage

Battlefield triage and mass casualty management protocols for tactical environments

Tactical Triage Protocols

Systematic approaches to mass casualty triage in combat and tactical environments.

1

SALT Triage

Sort, Assess, Lifesaving Interventions, Treatment/Transport

Phases:
Sort
Assess
Lifesaving
Transport
2

START Triage

Simple Triage And Rapid Treatment

Phases:
Walk Test
Respirations
Perfusion
Mental Status
3

MASS Triage

Move, Assess, Sort, Send tactical triage

Phases:
Move
Assess
Sort
Send

Immediate (Red)

Priority 1
Treatment within minutes

Life-threatening injuries requiring immediate intervention

Triage Criteria

  • 1Compromised airway with potential for correction
  • 2Severe respiratory distress but salvageable
  • 3Uncontrolled hemorrhage amenable to treatment
  • 4Signs of shock with treatable cause
  • 5Penetrating chest trauma with pneumothorax
  • 6Severe burns <20% BSA with inhalation injury

Treatment Interventions

  • Immediate airway management
  • Hemorrhage control with tourniquets
  • Chest decompression procedures
  • IV access and fluid resuscitation
  • Pain management as appropriate
  • Rapid evacuation priority

Clinical Examples

Tension pneumothorax
Arterial hemorrhage
Airway obstruction (correctable)
Severe shock (treatable)
Major burns with airway compromise

Resource Allocation

Personnel:

High resource allocation, multiple personnel

Survival Rate:

High survival with immediate care

Time Sensitivity:

Treatment within minutes

Triage Categories Overview

Complete triage system for mass casualty incidents

1
Immediate (Red)
Treatment within minutes
Priority 1
2
Delayed (Yellow)
Treatment within hours
Priority 2
3
Minimal (Green)
Self-care or delayed treatment
Priority 3
4
Expectant (Black)
Comfort care only
Priority 4

Tactical Triage Considerations

Threat Environment:

Modify triage decisions based on ongoing threats and tactical situation. Safety of responders is paramount.

Resource Scarcity:

Limited medical resources require difficult decisions. Focus on greatest good for greatest number.

Evacuation Capacity:

Consider evacuation capabilities and timelines when making triage decisions.

Communication:

Maintain clear communication with command structure and medical evacuation assets.

Implementation Guidelines

Initial Assessment:

Rapid 30-second assessment focusing on airway, breathing, circulation, and mental status.

Triage Tags:

Use standardized triage tags with color coding, time stamps, and intervention documentation.

Continuous Reassessment:

Patient condition can change rapidly. Reassess triage categories as resources and situation evolve.

Documentation:

Maintain accurate records of triage decisions and interventions for after-action review.

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