Field Triage Tools in Mass Casualty Incidents: A Narrative Review

Abstract

Mass casualty incidents (MCIs) pose significant challenges to healthcare systems, requiring rapid and effective triage strategies to optimize patient outcomes and resource utilization. This narrative review explores the evolution, effectiveness, ethical considerations, global perspectives, and future directions of field triage tools in MCIs. Beginning with the historical perspective, milestones in triage development, such as the Simple Triage and Rapid Treatment (START) protocol and its adaptations like Jump START and Sort, Assess, Lifesaving Interventions, Treat/Transport (SALT), are discussed. Current field triage systems are evaluated, including their application, limitations, and impact on patient outcomes. Training and education programs, challenges in triage education, and ethical/legal considerations in resource allocation and informed consent are examined. Global variations in triage systems, cultural factors, collaboration efforts, and standardization initiatives are explored to understand regional differences and promote interoperability. Future directions emphasize enhancing triage accuracy, integrating triage with healthcare systems, and research priorities. The review concludes with implications for practice and policy, calling for continued research, collaboration, and innovation to advance field triage capabilities and improve emergency response worldwide.