Medical Triage: Code Tags and Triage Terminology

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Medical Author: Melissa Conrad Stoppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FAC
Triage refers to the evaluation and categorization of the sick or
wounded when there are insufficient resources for medical care of
everyone at once. Historically triage is !elieved to have arisen from
systems develo"ed for categorization and trans"ort of wounded soldiers
on the !attlefield. Triage is used in a num!er of situations in modern
medicine including:
#n mass casualty situations triage is used to decide who is most
urgently in need of trans"ortation to a hos"ital for care $generally
those who have a chance of survival !ut who would die without
immediate treatment% and whose in&uries are less severe and must wait
for medical care.
Triage is also commonly used in crowded emergency rooms and walk'
in clinics to determine which "atients should !e seen and treated
immediately.
Triage may !e used to "rioritize the use of s"ace or e(ui"ment
such as o"erating rooms in a crowded medical facility.
#n a walk'in clinic or emer!enc" department an interview with a triage
nurse is a common first ste" to receiving care. He or she generally
takes a !rief medical histor" of the com"laint and measures vital signs
$heart rate respirator" rate tem"erature and blood press#re % in order to
identify seriously ill "ersons who must receive immediate care.
#n a hos"ital triage might "revent an o"eration for an elective $aceli$t
from !eing "erformed if there are numerous emergent cases re(uiring
use of o"erating facilities and surgical nursing staff.
#n a disaster or mass casualty situation different systems for triage
have !een develo"ed. )ne system is known as STA*T $Sim"le Triage and
*a"id Treatment%. #n STA*T victims are grou"ed into four categories
de"ending on the urgency of their need for evacuation. #f necessary
STA*T can !e im"lemented !y "ersons without a high level of training.
The categories in STA*T are:
the deceased who are !eyond hel"
the in&ured who could !e hel"ed !y immediate trans"ortation
the in&ured with less severe in&uries whose trans"ort can !e
delayed
those with minor in&uries not re(uiring urgent care.
Another system that has !een used in mass casualty situations is an
e+am"le of advanced triage im"lemented !y nurses or other skilled
"ersonnel. This advanced triage system involves a color'coding scheme
using red yellow green white and !lack tags:
*ed tags' $immediate% are used to la!el those who cannot survive
without immediate treatment !ut who have a chance of survival.
,ellow tags' $o!servation% for those who re(uire o!servation $and
"ossi!le later re'triage%. Their condition is sta!le for the moment
and they are not in immediate danger of death. These victims will
still need hos"ital care and would !e treated immediately under
normal circumstances.
%reen ta!s' $wait% are reserved for the -walking wounded- who will
need medical care at some "oint after more critical in&uries have
!een treated.
.hite tags' $dismiss% are given to those with minor in&uries for
whom a doctor/s care is not re(uired.
&lack ta!s' $e+"ectant% are used for the deceased and for those
whose in&uries are so e+tensive that they will not !e a!le to survive
given the care that is availa!le.
0rou" Color
Ty"e of
Trauma
Systems
Triage
1evel
of
Care
Emergent ed
Critical2 May
survive if
sim"le
lifesaving
measures are
a""lied
Arterial !leeding
*es"iratory
Cardiovascular
# ##
3rgent 'ellow
1ikely to
survive if
sim"le care
is given
within hours
Cardiovascular
Hemorrhage and
Transfusion
4eurological
Musculoskeletal
A!dominal
# ##
4onurgent %reen Minor trauma2
care may !e
delayed while
other
"atients
4eurological
Musculoskeletal
A!dominal
## ###
#5
receive
trauma
Catastro"hic &l#e
6atients are
unlikely to
survive or
those who
need
e+tensive
care within
minutes
4eurological #
4one &lack
7ead or
severely
in&ured and
not e+"ected
to survive
Any of the a!ove
## ###
#5
et#rn to Tra#ma (omepa!e