I suggest we need to modernize triage training and planning. START has been around now for many years. Studies to validate the system have been inconsistent. With a huge body of material now available on Altered or Crisis Standards of Care and extremely large incidents (sometimes called Mass Casualty Events), it's time to incorporate some of this work into EMS and ED plans.
I suggest that when triaging significant numbers of patients at extremely large incidents (sometimes called Mass Casualty Events as opposed to Mass Casualty Incidents), there can be a need for an additional level of triage. Years ago, that was incorporated in some triage plans as a "Yellow Prime" category. The concept was similar to Expectant. Victims whose injuries were so severe that their chances of survival were ...more »