Hospital Triage System in Mass Casualty Incident

ABSTRACT

PURPOSE: Effective triage at the emergency department entrance is the key to dealing with mass casualty incidents. However, in Korea, triage has been accomplished at the disaster scene or at the hospital in only a few cases. Thus, we report on the planning and preparation for triage at Asan Medical Center (AMC) for mass casualty incidents. METHODS: We review the AMC disaster plan and the triage systems used in previous disasters. Also, we review triage principles appearing in the literature. We describe basic hospital triage principles, which include the treatment site, the triage site, the triage officer, triage categories, and triage tags. RESULTS: 1) For external disaster, the emergency department is reassigned to four treatment sites before patients arrive. At the triage site, an emergency medicine specialist classifies patients into six groups according to treatment priority and resources. After classification, a triage tag is attached to each patient, and patients are moved to the previously designated treatment site. 2) For internal disaster, the head nurse (or senior nurse) classifies patients into three groups: urgent, minor, and delayed. The minor group is sent to the casualty collection point while the urgent and delayed groups are moved to the triage site. CONCLUSION: Hospitals should prepare a disaster plan. In particular, preplanning for triage is essential to cope with internal and external disasters. In addition, emergency medicine specialists should play a key role in disaster planning and are essential for successful implementation of the disaster plan.