Triage and

Disaster
Management

Definition of Triage
Derived from French word, trier
which means to sort.
A method of quickly identifying
victims who have immediately lifethreatening injuries and who have
the best chance of surviving.
System of priorities to maximize the
number of survivors.

Triage during disaster

Mass-casualty or multi-casualty
incident
Involves more than one victim
Aim :
Sort the victims in order of severity
Based on their medical need
Based on the available resources
Provide the best outcome for the
greatest number of patients

 Disaster triage vs emergency

department triage :
During a disaster with limited
resources, victims with little or no
chance of survival are not
resuscitated.

5s Rule
Safety assessment
Assess the scene for safety
Self-protecting measures

 Scene size up
Size of the scene area
Type of incident
Estimate the number of patients
Severity of injuries
The access route
Send information
Information regarding the scene size
up
Request for assistance and additional
resources

 Setting up scene
Safe and sheltered location to move the
patients
Obtain triage ribbon to mark the
patients
Consider scene access and egress
START triage process
Simple Triage And Rapid Treatment
To allow rapid assessment of
respiration, perfusion and mental status
(RPM).

START triage scale

Colour
Red

Yellow

Green

Black

Category
Patients who need immediate
care and transport as soon as
possible.
Patients whose treatment and
transportation can be
temporarily delayed.
Patients whose treatment and
transportation can be delayed
until last.
Patients who are already dead
or have little chance for
survival.

START STEP 1
Can the patient walk ?
YES
Green /
Minor

NO
Evaluate
respiration STEP
2

START STEP 2
Respiration
present?
NO

YES

Open airway
< 30/min

>
30/min

Evaluate
perfusion
STEP 3

Red /
Immedia
te

No respirationsRespirations
Black /
Deceas
ed

Red /
Immedia
te

START STEP 3
Perfusion
Absent Radial
Pulse

Present Radial
Pulse

Control
Hemorrhage
Red /
Immedia
te

Evaluate
mental status
STEP 4

START STEP 4
Mental status
Cant Follow Simple
Commands

Can Follow Simple

Commands

Red /
Immedia
te

Yellow /
Delayed

Definition of Disaster
Incident that occur in a sudden manner,
complex in nature, resulting in the loss of lives,
damages to the property or the environment
as well as affecting the daily activities of local
community.
Requires the handling of resources, equipment,
frequency and extensive manpower from
various agencies as well as effective
coordination.
National Security Council (NSC) Directive 20
1997

Types of Disaster
Natural disaster such as floods and
landslide
Accidents involving transportation
Collapse of high rise buildings
Major fire incidents
Air and environmental disasters such
as haze
Industrial disasters such as explosion
and emission of hazardous materials

Policy and Mechanism

Under the National Security Council, an
organisation was formed to manage on
scene incident in major disasters on land.
Disaster Management and Relief
Committee that was established at
Federal, State and District level.
Disaster Operation Control Center at each
level : Monitor the progression in term of
search, rescue and relief efforts to the
victims.

 On scene post (at the incidence scene)

Commander : Police
Deputy commander : Fire and Rescue
Department
Roles:
To assess, manage and coordinate all search
and rescue efforts at the incident scene.
Request assistance at higher level (if
required).
To appoint officers and personnel from Royal
Malaysia Police (RMP) and other agencies as
responders to disaster management.
Communicate with the Disaster Operation
Control Center.

Agencies roles at disaster site

Roles
Search and rescue
Health and medical
Security control
Support
Media
Welfare

Agency
Police, Fire and Rescue
Department, SMART, Army
Emergency Medical Service,
Malaysia Red Crescent
Police, RELA, Army
Local authorities, TNB,
TELEKOM
Information and
broadcasting department
Welfare department