DISASTER

TRIAGE
DODY SETYAWAN
What is a triage?
• Triage is the process of prioritizing which
patients are to be treated first and is the
cornerstone of good disaster management in
terms of judicious use of resources (Auf der
Heide, 2000)
• Accurate triage  do intervention based on
priority case minimalizing mortality
• Sorts the victim according to priority which
must first be helped / transferred give
color/label
Personal abilities that are essential to be an
effective triage officer:
 Daily Triage

Incident Triage

Concept Categories
Disaster Triage
of Triage Process
Tactical-Military
Triage
Special Condition
Triage
Daily Triage….
• a routine basis everyday in the emergency
department (ED)
• The goal: identify the sickest patients in order
to assess and provide treatment to them first,
before providing treatment to others who are
less ill
• Provided to the most seriously ill patients,
even if those patients have a low probability
of survival.
Incident Triage…
• Occurs when the ED is stressed by a large
number of patients
• Still able to provide care to all victims utilizing
existing agency resources need on call staff
• Disaster plan  do not have to be activated
• Still provided to the most critically ill patients
Tactical-military triage
• Similar to disaster triage, only military mission
objectives rather than traditional civilian
guidelines drive the triage and transport
decisions
Special Conditions Triage…
• It is used when patients present from
incidents such as radiation, biological, or
chemical contaminants
• These triage situations mandate personal
protective equipment for all health care
personnel and decontamination capabilities at
the facility
• The triage officers must assure do not
become a victim
Disaster Triage…
• Always be a difficult and daunting task
• Nurse must accurately decide which patients
need care, the location of the care, who receive
care first, and in situations of severely
constrained resources, who should not receive
care at all
• Triage in ED preparation for disaster triage, but
if large-scale disaster, mass casualty incidentsto
perform triage at the scene of the event
• The goal : identifying injured or ill patients
who have a good chance of survival with
immediate care that does not require
extraordinary resources

SHORT CATEGORIES
 Critical Urgent Minor Catastrophic
Casualties Casualties Casualties Casualties
• Life • Serious • Not require • Use for very
threatening Condition rapid serious
• Be amenable • If not treat in intervention condition and
to rapid time  • A delay in prognosis
intervention deteriorate to treatment  • Require an
that does not become not contribute amount of
require an critical to significant resources
inordinate • Ex: Fracture, deterioration • Will not be
amount of Cervical Spine • Ex: Minor treated until
resources Injury, Severe Laceration the critical
• Ex: Airway Bleeding and urgent
Obstruction • Referred to cases are
hospital attended to
 Hospital
Disaster Setting
Triage Pre-hospital
Setting
Disaster Triage Hospital Setting….
• Remember that during a disaster situation,
non-disaster patients will continue to arrive at
the ED
• Provisions need to be made for these patients
as well, as there is a risk of being ignored in
the fray
Disaster Triage in Pre-Hospital…

Disaster
Triage
System

JumpSTART
START SAVE
System SALT
System System
(Pediatric)
 Simple Triage and Rapid Treatment
(START) System

• It is based on the person’s ability to respond

verbally and ambulate and their respirations,
perfusion, and mental status (RPM)
 Reference
• Auf der Heide, E. (2000). Triage. In Disaster
response: Principles of preparation and
coordination. St. Louis, MO: CV Mosby. Retrieved
June 1, 2006 from http://orgmail2.coe-
dmha.org/dr/DisasterResponse.nsf/section/4095
83F8918DD44A0A25692A007C87F5?opendocum
ent&home=html
• Veenema TG. (2007). Disaster Nursing and
Emergency Preparedness for Chemical, Biological,
and Radiological Terrorism and Other Hazards. 2nd
Edition. New York: Springer