In this post, we will learn about Disaster Triage Nursing, the Triage Color Tags and what they mean, and the START method.
Disaster Triage Nursing
Triage is a process of examining patients and sorting them out according to the degrees of urgency of their presenting symptoms. Triaging is also done in situations or a disaster with mass casualties where healthcare providers are overwhelmed with victims that require immediate attention having limited resources to cater to everyone’s needs.
A triage nurse should be trained, experienced, and skilled to be able to determine the severity of illness and to what group the patient should be tagged. The Triage Tagging System has 4 disaster color codes: RED, YELLOW, GREEN, and BLACK.
Disaster Triage Color Tags
In order to group and prioritize patients according to their emergency of treatment, a color-coded tag serves as a label placed on each of them. A quick glance from other healthcare personnel and providers would immediately indicate their triage priority.
Red Tag: IMMEDIATE
The color red is universally recognized as STOP! When the patient is tagged as red, a healthcare provider would have to STOP and get this patient immediate attention or a life-saving treatment for they are a top priority. These patients should not wait for another minute for they could be in a life-threatening situation but could likely survive if given immediate intervention.
Here are some of the conditions that would require immediate attention and should be tagged RED:
- A patient in shock with internal or external hemorrhage, inadequate breathing, and slow capillary refill.
- A patient with a spinal cord injury following a trauma, could experience total loss of sensory and motor functions, as well as a neurogenic or cardiogenic shock, which would require immediate intervention to prevent excessive damage.
- A patient with second to fourth-degree burns with partial or complete skin destruction affecting more than 20% of the victim’s total body surface area.
Yellow Tag: DELAYED
Patients are tagged yellow when their treatment may be delayed for an hour or two. Some may have stable conditions at the moment but would be needing a possible re-triaging later. In short, these victims are under observation. They do not need immediate treatment but still need medical attention. But keep in mind that yellow-tagged patients could possibly become red-tag candidates.
Examples of conditions for which treatment may be delayed:
- Minor burns covering only 15% of the victim’s total body surface area
- Minor wound, discoloration, or abrasions
- Minor fractures that need immobilization like fingers, arms, or legs
Green Tag: MINOR
Green means GO! Patients tagged as green could still get up and go about. These are wounded victims that have minimal injuries and the most stable condition. Their treatment may be delayed for several hours but they still need medical care and first aid.
Here are some patient conditions that can be tagged as Green:
- Patients with moderate blood loss
- Conscious patients with normal breathing, normal mental status, and stable vital signs
Black Tag: EXPECTANT
Patients who are unresponsive or dead are tagged black. These include victims who are pulseless and have no respirations for more than 20 minutes and with severe injuries that even resuscitation procedures could not help.
What is the START method?
START is an acronym that stands for “Simple Triage and Rapid Treatment”. It is a triage method used by first responders on the scene to quickly assess and classify victims based on the urgency of the condition. It focuses on the patients’ signs and symptoms.
There are 4 things to check when using START:
- If the patient is able to walk or follow directions
- Pulse Rate
- and Mental Status