Triage

Oleh : Tim Emergency

Poltekkes Kemenkes Malang
 Definition

Triage is a process that

sort of patient as
base of life threating
.

History : Napoleon
Bonaparte (War I)
 PRINCIPLES OF TRIAGE

1. Triage should be immediate & timely

2. Asses should be adequate & accurate
3. Decisions are made based on assess .
4. Provide interv accord to acuity condition
5. Patient satisfaction is achieved
6. Complete of documention
 TRIAGE AT HOSPITAL SETTING

1. Priority 1 or Emergent
2. Priority 2 or Urgent
3. Priority 3 or Non-Urgent
4. Priority 4 or Dead
 METTAG
•Priority 0 =
•Priority 1 =
•Priority 2 =
•Priority 3 =
 Priority 1
 Patients with life threatening injuries or
illness which require immediate

 Area of Care :
Resuscitation Room or
Trolley/Stretcher
Waiting Time

a. Cardio-vascular collapse : zero

b. Don’t require resuscitation : < 5 mnt.

 Priority 2
 Urgent patients but who are not in
imminent danger of collapse.

 Patients on a trolley or a wheelchair.

Area of Care
 Wheelchairs & ambulatory setting.

Waiting Time
 Within 30 minutes of arrival at A&E.
 Priority 3
Ambulatory with minor problems, old injury
Does not require immediate threat to
patients life or limb.

Be treated in a private clinic or polyclinic.

 PRIORITY 1
1. Airway obstruction
2. Cardio-pulmo arrest
3. Shock states
4. Acute severe chest
pain
5. Acute head injuries
with loss of consc
6. Dsb
 PRIORITY 2

1. Upper limb fract

2. Multiple superficial
wounds
3. Burns < 15%
4. Febrile not requiring
critical care
5. Mild abdominal pain
 PRIORITY 3
1. Old scars
2. Deform of bones
3. Joint contractures
4. Patching of earlobe
5. Removal of tattoo
6. Requests for
circumcision
ASSESSMENT & PRIORITY

The SOAP process

 S :Subjective  A :Assess

 O :Objective
 P :Plan
(priority & plan)
?
Role of Field Triage Team

 First team arrive will take charge of triage

 Not to be stretcher bearers.
 Explain role of stretcher bearers to them
when assigned.
 Show the locations of P1, P2, P3
 All P1 & P2 casualties : via stretchers.
 Assist in other areas when no more
patients require triage.
 Not more than 2 P1 : in the same
ambulance.
 Load & go philosophy of field care.
 Triage Team
 Consist of 1 doctor & 1 nurse
 The number depent of availability,
requirement dan space.

 During disaster, fungtion is mainly to

alocate priority of treatment
 Triage Team
The equitment :

1. Triage tag , Stretchers

2. 1 box of dressing & OFT/NFT
 Start Method
(Simple Triage & Rapid Treatment)

 The triage personnel is minimal training.

 Assess is done very rapidly < 60 s :

1. Ventilation
2. Perfusion & pulses
3. Neurological.
 PROBLEM

non-medical may be
staff missed

Ex.
spinal
shock
Triage Proses in Disaster
1. Mobility ?
If victim can walk & has injury : P3
2. Cek ABC
 Airway (chin lift / jaw thrust)
B+ B- P1

Tdk dpt

< 10 x 10 - P0 ikut
perintah
> 30 x 30 x

Kesada Dpt ikut

C ran perintah

P1
CRT > 2 dtk / CRT < 2 dtk
Nadi - Nadi + P2
Problems

1. Language
2. No Visible Patient
3. Terms
4. Evaluation
4 categories are sorted into:

Decide to call for an ambulance (995)

Decide to be seen in an A&E Dept.
Decide to be seen by general
practitioner
Decide if first aid advice
 General Conduct over the phone:

1. Always identify yourself

2. Be calm & sound confident
3. Speak clearly
4. Substitute medical terms or explain them if
used
5. Be patient with the caller
Thank ........