CONCEPT: Triage

Triage: Sometimes called surgical triage (see Perrin, 1996: 226-232), triage has been defined as the “classification of the injured... undertaken by medical or paramedical personnel on site on the bases of seriousness of the injury and the chances of recovery" (UNDRO, 1984: 63-64). Likewise, WHO points out that "The underlying principle of triage is allocation or resources in a manner ensuring the greatest health benefits for the greatest number". 

As a principle, triage gives care givers, in situations of widespread trauma and shortage of care, the power and authority to decide who will be given available medication or surgery or other kind of help ( first or at all) and who will not -- based on their professional assessment of the course(s) of action that will do the most good. Thus, if they determine that a person is dying anyway, they may choose to withhold further medication. This principle extends to deciding, for example, who in a danger zone (or war zone, or sinking ship, or refugee camp) will be evacuated first, and who will have to wait; who, in a famine situation, will be fed first, or at all, and who will not.

The humanitarian community has been accused of being slow to translate that principle (or concept) into firm standards for classifying injuries and prioritizing the injured for emergency medical care. However, attempts have been made to rectify this. 
Indeed, during the 1980 earthquake in Algeria's El Asnam region, for example, four triage categories were adopted to prioritize medical care for the victims -- under conditions of severe supplies, HR and facilities constraints. 

Ranked by assessed need for urgent attention, these now iconic categories were specified as follows: 
1) Vital organs affected; 
2) Serious injuries which, after 'adequate' first aid (given by nurses and trained volunteers, under "general supervision"), could wait for up to 12 hours for an operation; 
3) Hopeless cases "needing comfort as much as treatment"; and 
4) Slightly injured persons whose fretting and noisy demand for attention might cause panic within the triage facility or camp (UNDRO, 1984: 63-4).  

READ: Pierre Perrin (1996) Handbook on War and Public Health. Geneva: ICRC


Updated: March 31, 2018