Triage is a system used by medical or emergency personnel to ration limited medical resources when the number of injured needing care exceeds the resources available to perform care so as to treat the greatest number of patients possible.
When performed in accordance with accepted medical practices, triage is recognized and sanctioned by law in most countries.
Advanced triage
In advanced triage systems, typically implemented by paramedics, battlefield medical personnel or by skilled nurses in the emergency departments of hospitals during disasters, injured people are sorted into five categories. "Tear-off" tags are sometimes used for this purpose. In the UK, a dynamic triage tag like the "Cruciform" is used, as this allows the patient categorisation to show improvement or deterioration. If immediate treatment is successful, the patient may improve (although this may be temporary) and this improvement may allow the patient to be categorised to a lower priority in the short term. Triage should be a continuous process and categories should be checked regularly to ensure that the priority remains correct. The difficulty with a triage tag with tear off sections, is that the patient is only shown to deteriorate; the dynamic card allows the priority to move up or down.
Black / Expectant
They are so severely injured that they will die of their injuries, possibly in hours or days (large-body burns, severe trauma, lethal radiation dose), or in life-threatening medical crisis that they are unlikely to survive given the care available (cardiac arrest, septic shock); they should be taken to a holding area and given painkillers to ease their passing.
Red / Immediate
They require immediate surgery or other life-saving intervention, first priority for surgical teams or transport to advanced facilities, "cannot wait" but are likely to survive with immediate treatment.
Yellow / Observation
Their condition is stable for the moment but requires watching by trained persons and frequent re-triage, will need hospital care (and would receive immediate priority care under "normal" circumstances).
Green / Wait
They will require a doctor's care in several hours or days but not immediately, may wait for a number of hours or be told to go home and come back the next day (broken bones without compound fractures, many soft tissue injuries).
White / Dismiss
They have minor injuries; first aid and home care are sufficient, a doctor's care is not required.
Note that this scale is much more complex than with simple triage. Medical professionals should refer to professional texts and training references when implementing advanced triage; this listing is only for a layperson's understanding.
Some crippling injuries, even if not life-threatening, may be elevated in priority based on the available capabilities. During peacetime, most amputations may be triaged "Red" because surgical reattachment must take place within minutes—even though strictly speaking, the person will not die without a thumb or hand.
On the first day I followed one nurse who was positioned at the front for triage. Patients signed up their names and they were called one by one in order. When a patient walked in, the nurse asked him what illness he had, checked his vital signs, and checked his past medical records. As she was doing all these she was also adding all these information to the patient's medical record account. She asked him, "how much pain are you in right now, in a scale of 1 to 10 where would you put yourself?" After all these procedures are performed, the patient is sent back to the waiting lounge till a doctor decides whether to admit him or send him back.In most cases, homeless people come in with an excuse of feeling dizzy, having chest pain or substance abuse. When asked how much pain he's under, the patient always says "it's 10 it's killing me doc." One doctor told me "you can always tell when they fake one."
Every cold night there are at least 6 to 7 homeless people wandering about trying to get in past the security guard and sleep inside.
