Topic Highlight
Copyright ©2010 Baishideng Publishing Group Co.
World J Orthop. Nov 18, 2010; 1(1): 10-19
Published online Nov 18, 2010. doi: 10.5312/wjo.v1.i1.10
Table 1 Classification of multiple casualty incidents
Natural disastersMan-made disasters
Causes of large scale physical destruction to manmade objects and infrastructureHazardous material incidents and Industrial accidents
EarthquakesRadiation exposure
VolcanoesChemical exposure
MudslidesInhalation injury
AvalanchesExplosive disasters
TsunamiTransportation accidents
Tropical storms, hurricanes, tornadoesAircraft
Extreme heat, coldHighway
War related
Fire relatedMilitary casualties
Thermal injuryCivilian casualties
Inhalation injuryInnocent bystanders
Infrastructure, agriculture, and domiciliary damageMilitary targets
Mass casualty
Major societal dislocations and refugee populations
Malnutrition, epidemics
Table 2 Commonly accepted triage coding categories
PriorityNeed for treatmentColor codeCharacteristics
1ImmediateRedLife-threatening shock or hypoxia is present or imminent, but the patient can be likely stabilized and will probably survive if given immediate care
2UrgentYellowInjuries have systemic effects or implications, but the patient is not yet in life-threatening shock or hypoxia. Despite the chance that systemic decline may ensue, this group can likely withstand a 45- to 60-min wait without immediate risk. Patient likely to survive if given appropriate care
3Non-urgentGreenLocalized injuries without immediate systemic implications. With minimal care, these patients are unlikely to deteriorate for several h (or not at all)
4ExpectantBlackMost severely injured patients who have poor chance for survival regardless of care rendered. No distinction is made between clinical and biological death. In multiple casualty incidents, any patient who is unresponsive or who has no spontaneous ventilation or circulation is classified as dead
Table 3 The chest, abdomen, vena cava, and extremities for acute triage protocol summary
DescriptionIdentification of immediately and potentially life-threatening injuries (FAST + pneumothorax)Intravascular status evaluation (IVCCI)Hemothorax assessmentExtremity assessment (lower → upper extremity sonography)
Skill levelEasyIntermediateDifficult
UrgencyPrimary triage & assessment (Mandatory)Secondary triage & assessment (Optional)