Prehospital Triage

In prehospital care (paramedics), when we arrive on a scene and have more victims than we have paramedics or resources to treat the patients we follow a trauma triage tagging system. Unfortunately, most states have a different variance on the trauma triage tagging system.

The concept of prehospital triage, like hospital triage is that you recognise that you cannot help everyone, so your aims and objectives must target providing the most amount of good for the greatest amount of people. This means that your treatment plans may vary considerably from when you have only one patient to contend with.

In NSW, paramedics will immediately notify their communications centre that there is a multiple victim situation and take a walk around, head count of the victims at the scene. At this stage, the only treatment that will occur is removing patients from immediate danger (if it can be done safely) and basic airway manouvers, such as rolling patients on their side and head tilt.

The triage labels in NSW include the following:

Green – this is for walking patients. If they can walk, they’re probably not your main concern right now ( but this does not mean that they can’t deteriorate later, so keep all your green patients together where you can still check up on them).

White – This is for victims who are not able to maintain their own airway (after simple aireway manoeuvres, such as head tilt, rolling the patient) and basically states that the patient is dead and not to be worked on.

Red – Very sick. These are life-threatening patients who require your help as early as possible. Identified by victims with a respiratory rate of less than 10 or greater than 30 or with a capillary refil of greater than 2 seconds.

Orange – Potentaillly lifethreatening. These patients can deteriorate. They are identified as having a respiratory rate within the 10-30 rate range and a capillary refil of less than 2 seconds, but are currently unable to walk.