Mass Casualty Triage: An Evaluation of the Data and Development of a Proposed National Guideline

Abstract

Mass casualty triage is a critical skill. Although many systems exist to guide providers in making triage decisions, there is little scientific evidence available to demonstrate that any of the available systems have been validated. Furthermore, in the United States there is little consistency from one jurisdiction to the next in the application of mass casualty triage methodology. There are no nationally agreed upon categories or color designations. This review reports on a consensus committee process used to evaluate and compare commonly used triage systems, and to develop a proposed national mass casualty triage guideline. The proposed guideline, entitled SALT (sort, assess, life-saving interventions, treatment and/or transport) triage, was developed based on the best available science and consensus opinion. It incorporates aspects from all of the existing triage systems to create a single overarching guide for unifying the mass casualty triage process across the United States.

First Responder Accuracy Using SALT after Brief Initial Training

“…2 transport (SALT) triage algorithm in 2008. 7 Although SALT triage remains a relatively new algorithm, evidence continues to accumulate documenting its accuracy in not only paper-based case scenarios, but also during mock disasters. [8][9][10][11][12][13][14][15] However, broad international adoption has yet to occur, with regional variation in utilization of the SALT triage algorithm remaining the norm.…”

Mexico City's Petroleos Mexicanos Explosion: Disaster Management and Air Medical Transport

“…12,13 These triage protocols will continue to be refined as we gain a deeper understanding of mass casualty management and as further evidence is collected to identify an optimal disaster triage method.…”

Scarce Resources for Nuclear Detonation: Project Overview and Challenges

“…31 The emphasis is on iterative assessment, because the victims' medical conditions and the availability of resources may change rapidly over time, allowing them to move from the expectant (likely to die) category into the immediate or delayed treatment categories. Palliative/comfort care is an important component of the medical response and resources should be allocated for this and for saving lives.…”