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Triage (pronounced ‘tree-ahz’), is a French word used in the first aid and medical contexts to indicate the sorting and classification of casualties, and the establishment of treatment priorities. It usually refers to a mass casualty situation, such as an earthquake or bus accident.

Even though triage generally applies to large numbers of casualties, it is also relevant to other first aid situations involving two or more casualties.

There are times when members of the public, trained in first aid, have had to make decisions on the treatment and care of casualties which normally would have been the responsibility of ambulance officers or a doctor. This is especially relevant in country areas where medical aid may be some hours away. A common example of this circumstance is when a member of the public travelling a remote country road comes across a motor vehicle accident involving several casualties.

Unfortunately, to effectively provide the best treatment for the most needy, some seriously injured casualties may have to be temporarily ignored. Basically, the requirement is for your limited first aid resources to be allocated to the casualties who will survive because of it, and not to those who are likely to die.

To triage an incident, your approach has to be objective. To assume the responsibility for these decisions is an unenviable position to be in.

You should ask yourself three questions:

1. Who needs immediate treatment to save their life?
2. Who will really benefit, and who won’t?
3. If I treat one person, will others suffer seriously from lack of attention?

Safety, airway, breathing, circulation, control of severe bleeding, shock, and burns, are still the priorities when attending multiple casualties with little, or no assistance.

Casualties in cardiac arrest are only given CPR if there are no other seriously injured casualties requiring life-saving treatment. If you become distracted with a casualty in cardiac arrest, you will be fully committed performing CPR (usually to no avail), at the expense of another who may be saved by your active intervention.

An unconscious casualty on their back, a person with severe bleeding, a casualty with a head injury going into shock – all are high priorities because without your intervention they may die. A conscious casualty with a fractured leg is less urgent and can wait until the more serious casualties are dealt with. A conscious casualty walking around, complaining of a sore shoulder, for example, is at the bottom of the triage list.

The most knowledgeable or experienced person present should undertake triage.