Field Triage

What Is Field Triage?

Field triage is the rapid sorting of patients at the scene of a mass-casualty incident (MCI) into treatment and transport priority categories — typically Immediate (red), Delayed (yellow), Minor (green), and Expectant/Deceased (black) — using standardized algorithms such as START or SALT. The goal is to do the greatest good for the greatest number by directing limited ambulances and receiving hospitals to the most salvageable critically injured patients first, rather than treating patients on a first-come basis.

Why Field Triage Matters on the Fireground

In an MCI with more patients than available resources, untriaged scenes devolve into chaos. Systematic field triage ensures that patients with time-critical injuries — tension pneumothorax, uncontrolled hemorrhage, airway compromise — reach definitive surgical care within the golden hour, while walking wounded are directed to secondary treatment areas without consuming ALS transport capacity.

Relevant NFPA Standards

• NREMT Standards: National Registry of Emergency Medical Technicians Practice Standards
• NFPA 455: Standard for Emergency Medical Services (EMS)

Field Procedures & Tactical Steps

1. Establish a triage officer and begin systematic patient assessment using START (30-2-can do) or SALT (Sort-Assess-Lifesaving-Treat/Transport) protocols.
2. Tag each patient with the appropriate color category: Immediate (red), Delayed (yellow), Minor (green), or Expectant (black).
3. Direct walking wounded (green) to a designated collection point away from the treatment area to free space and resources.
4. Coordinate with transport officer to prioritize red-tagged patients for ALS ambulance transport to trauma centers.
5. Reassess all tagged patients at regular intervals — conditions change, and a yellow patient can deteriorate to red.

Common Context & Application

Applied at MCI scenes including vehicle pileups, building collapses, active shooter aftermaths, and natural disasters where patient count exceeds initial ambulance availability.

Frequently Asked Questions about Field Triage