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TRIAGE SYSTEMS

FOR TRAUMA CARE

DEFINITION
Process of determining the priority of
patients treatments based on the
severity of their condition

Mechanism that is essential for effective


management of modern emergency services.

Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.

PRINCIPLES OF TRIAGE

To ensure that the


patient receives the
level and quality of
care appropriate to
clinical need.

That resources are


most usefully
applied

Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.

TRIAGE SCALES
Help health
professionals

classify
patients
consistently
To achieve
acceptable
outcomes
Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.

The Most Commonly Used


Scales
IPSWICH

ATS

CTAS

Five category
scale in which
the functional
urgency is
based on
nurses
determination of
the patient
condition.

Most common
and universal
system, which
is a direct triage
mechanism and
has a 5 level
categorical
scale.

Derived from
ATS. It is a 5
categorical
scale .

Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.

Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.

TRIAGE OUTCOMES
First

Secondly

The triage assessment which leads to


allocation of a triage category and subsequent
processing of the patient

Initiation of treatment to facilitate emergency


care with a possible reduction in the patients
discomfort

Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.

TRAUMA TRIAGE
Trauma triage is the use of trauma
assessment for prioritising of patients for
treatment or transport according to their
severity of injury
Primary triage is carried out at the scene of an
accident and secondary triage at the casualty
clearing station at the site of a major incident.
Triage is repeated prior to transport away
from the scene and again at the receiving
hospital
Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.

The primary survey aims to identify and


treat life-threatening injuries and based on
resuscitation system.

immediately
the ABCDE

Airway control with stabilisation of the cervical spine.


Breathing.
Circulation (including the control of external
haemorrhage)
Disability or neurological status.

Exposure or undressing of the patien while also protecting


the

patient

from

hypothermia

Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.

PRIORITY PATIENTS
Red

T1

Immediate priority

require immediate life-saving


intervention

Yellow

T2

Urgent priority

Require significant intervention within 2-4


hours

Green

T3

Delayed priority

Require intervention, but not within 2-4


hours

Blue

T4

Expectant priority

Treatment at an early stage would divert


resources from potentially beneficial
causalities, with no significant chance of a
successful outcome

Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.

TRIAGE SIEVE
Can
Can the patient walk?
Yes
Yes : Priority
Priority 33 (Green).
(Green).
No
No ::
Is
Is the
the patient
patient breathing?
No,
No, even
even after
after opening
opening airway:
airway: Dead.
Dead.
Yes,
Yes, after
after opening
opening airway:
airway: Priority
Priority 1 (Red).
(Red).
Yes,
Yes, without
without resuscitation:
resuscitation:
What
What is
is the
the respiratory
respiratory rate?
rate?
Above
Above 30/minute
30/minute or
or less
less than
than 10/minute: Priority
Priority 11 (Red).
(Red).
10-30/minute:
10-30/minute:
What
What is
is the
the pulse
pulse rate
rate (or
(or capillary
capillary refill
refill time)?
time)?
Less
Less than
than 40
40 or more than 120 (or capillaryrefill
capillaryrefill time
time greater
greater than
than 22
seconds):
seconds): Priority
Priority 1(Red).
1(Red).
Between
Between 40
40 and
and 120
120 (or
(or capillary
capillary refill
refill tim
tim less
less than
than 2 seconds):
Priority
Priority 22 (Yellow)
(Yellow)
Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.

TRIAGE SORT
PHYSIOLOGICAL VARIABLE

Respiratory rate

Systolic blood pressure

Glasgow Coma Scale (GCS)

VALUE

SCORE

10 29

29

69

15

90

76 89

50 75

1 49

13 15

9 12

68

45

A
A total
total score
score of
of 1-10
1-10 indicates
indicates priority
priority T1,
T1, 11
11 indicates
indicates T2,
T2, and
and 12
12 indicates
indicates T3.
T3.
Shuja
Shuja A,
A, Triage
Triage Systems
Systems For
For Trauma
Trauma Care.(2014).Indep
Care.(2014).Indep Rev;16(7-9):
Rev;16(7-9): 244-249.
244-249.