S. Triage. A. R. T.

"The bad artists imitate, the great artists steal." - Pablo Picasso H. Semat

Triage is a procedure of sorting of patients to priority-based category for transport and treatment according to degree of injury severity and medical emergency, in regard of first aid ABC system procedure (in field or hospital). Triaging includes selecting system in scene of accident by the responder and evacuating/transporting patients to the hospital or other health care facilities. For patient identification purposes, easiest way is by using colored-coded Triage Tag and the priority of patient management in triage are as follows:

• Highest Priority/Immediate/Class 1 (RED) : Emergency and life threatening patient (immediate care and life threatening)
• High Priority/Delayed/Class 2 (YELLOW) : Moderate and emergency patient (urgent care and can be delayed up to 1 hour)
• Immediate Priority/Minor/Class 3 (GREEN) : Emergency not life threatening, life threatening not emergency and not emergency and not life threatening (delayed care and can be delayed up to 3 hours)
• Last Priority/Class 4 (BLACK) : Probable death and patient with signs of death (victim is dead and no care required)

START on the other hand stands for Simple Triage and Rapid Treatment/Transport which is a modified triage commonly used in managing Multiple/Mass Casualty Incident (MCI). This system is done by the help personnel in 60 seconds or less for each patient and encompasses respiration, circulation and mental status examination. START system divides victims to 4 priorities exactly as in conventional triage with some modification as less time required to perform triage on mass victims.

• Immediate/Highest (RED)
• ventilation is present after airway is secured, or breathing is more the 30x/min
• capillary refill/filling more than 2 seconds
• unable to follow simple command
• Delayed/High (YELLOW)
• patient can't be categorized in immediate or minor
• Minor (GREEN)
• separated from the victims in the beginning of triage operation and usually known as "walking wounded"

Triage Tag is usually filled and done during the transport of victim to the hospital. Pay attention to details of;

1. time arriving to the scene of incident
2. date of incident
3. name (if conscious and coherent)
4. address
5. other important infomations
6. help personnel indentity
7. identification of traumatic patient (with photo)
8. vital sign and time of examination
9. record usage of IV drugs and other drug (advance life support)
10. place the tag on the cloth or on other part of easy to be noticed

 and examination of 3, 4, 5 can be postponed and completed in awaiting the transport team to be arrived.

Ref: Buku Panduan Pelatihan Basic Life Support TBMM FKUGM