Talk:Triage/Archive 1

Archive 1

Initial text

This definitely needs to be reviewed. I'm training as a certified disaster service worker, under FEMA-approved training, but a review/rewrite by a real MD or EMT would be better. Ray Van De Walker

Update/sources Needed

At Maine Medical Center we use a T1 to T4 scale. The article here mentions only 3 levels. This might need to be updated. Rlee0001 15:37 Jul 25, 2002 (PDT)

Different scales are used all over. Maryland emergency systems used a simply Priority 1 - 4 scale (1 = highest priority; 4 = dead or uninjured), and a quick scan of the article reveals that capillary refill is recommended for prioritizing victims. Capillary refill is notoriously unreliable in adults, though in a triage system it can be used if necessary. I think this is one person's system that he mistakenly thinks applies elsewhere. I'll see if I can fix it up one of these days. Tokerboy 13:43 Nov 13, 2002 (UTC)

I'd love to know how and why it fails. Anemia?

I wrote the original article in 2001. I'm not qualified to evaluate the method, but I'm a certified disaster service worker, and it really is the system we learned in CDSW class. From a training video for fire-fighters. I was told that here in California it's taught to a wide range of emergency service personnel, including the fire departments and police. Different regions probably use different labels. We learnt it for earthquake response, when emergency services are massively overloaded. Our trainers from the fire department said that it's been used successfully in school bus accidents and the like. I'm not very skillful, but I can follow instructions. For people like me, the capillary refill method may be much more reliable than other methods. I know that some of my classmates could not find their -own- carotid artery, and couldn't detect shallow breathing. Nobody in class had trouble finding fingernails or seeing them turn pink.

Best wishes, User:Ray Van De Walker 6 February 2003

I looked over this article at one point. Capillary refill is a lot better than nothing for unskilled persons, and it is only used to distinguish between "immediate" and "delayed" transport by unskilled persons. START is a regional system but is widely used here in California.

I am not qualified to edit this page but I would like to raise a point for discussion. My understanding of the original goals of Triage are completely at odds to the current admirable practices using the same name. It was to classify troops by how quickly they could be returned to battle. Those with the minor injuries were given the _first_ attention. Those requiring the most medical resource were left until it was available, often to their detriment. Bob Guthrie 27 May 2007

This article looks official, but it occurred to me that it doesn't list sources. If someone could do that, it would help with the accuracy, not to mention it must be done by WP standards. I'm tagging this for that. Garnet avi 17:49, 29 June 2007 (UTC)

Question

Just a quick question - in Triage 5, what is meant by " As you have time, tag walking wounded as "WALKING" and upgrade shock victims to "INJURED."? It seems a bit iffy to me. Thanks. Alex.tan 01:40, 2 Aug 2003 (UTC)

Concerning "Reverse Triage", is there really a difference between Reverse Triage and Advanced Triage? If the less seriously injured are treated before the more serious because of limited resources (including the treatment of injured medical staff to alleviate a shortage of personnel), the intention seems to be the same. If there is a significant difference, it needs to be clarified; otherwise maybe this section can be removed. —Preceding unsigned comment added by 161.6.206.17 (talk) 23:40, 20 July 2008 (UTC)

Advertising

Looking over some edits here I have a question for someone more knowledgable, there are a bunch of edits by Carl.wallin@btopenworld.com which all point to advertising for the "Cruciform" by cwc services, replacing earlier references to "Smart Tag" or "The Smart Incident Management System" my feeling is that this is an attempt by this user to replace a generic system with his company's specific brand, in other sections of triage he has added references to his website in the links section ("Details of the Triage Sieve document can be seen on the CWC Services website, link below.") also looking at that user's profile ALL their edits are in triage and related to this Cruciform. Can someone confirm if this system really is only "cruciform" rather than "smart" as previously listed? and wether we should be removing the advertising bias this user has added? Green1 18:26, 25 March 2006 (UTC)

---

ok... I think this is getting ridiculous, are we in a tug of war between two companies? tsgassociates and cwcservices seem to be going back and forth with their specific websites and links for their specific brand of triage cards... can we get a generic version put in with no link to any company? Green1 16:55, 11 April 2006 (UTC)

I agree this looks very suspect. I'm removing all links and references to commercial triage tags (and pros/cons of specific features on them) from the article. The picture of a tag will suffice. Ben Finn 13:14, 23 May 2006 (UTC)

Trauma scores?

This article keeps talking about judging triage by people's "trauma score" - less than 3 is mentioned, as is 10-12 - but there's no indication of how these "scores" are calculated or what they actually mean - I've never heard of them so I can't edit this, but is it possible to clarify or provide a link? Atalan 18:58, 27 March 2006 (UTC)

The Glascow Coma Score (GCS) is a rating from 3 to 15 (a dead person has a 3, an uninjured person has a fifteen) used by emergency medical technicians and emergency medical personnel. It is appropriate in single-patient medical emergencies and care provided by emergency rooms, etc. but not in a mass casualty incident by laypersons. The entire point of triage is that there is no time to use tools such as the GCS until all patients have been evaluated. clarka 29 June 2006

Copyvio?

A lot of this article, especially the START section, seems to be copied directly from some sort of manual. A google search for the section of text "If you have not called for help, point at a particular person, and forcefully ask them to call for help." returns many pages with the exact same text in this article. Any ideas?

French (Tire)

F.Y.I, the french meaning of the word "Tire" is not "to sort", rather "to pull", or "to tug". This should be considered for change to this article. 24.57.5.161 15:27, 23 July 2006 (UTC)

I believe you have confused the french verb "tirer" which means to pull, and the verb "Trier" which means to sort. As a result the reference to the french verb Trier in the article is in fact accurate. Reference: Collins Parperback French Dictionary - French English, 2nd edition ISBN 0 00 470210 7, 1995 Harper Collins. —Preceding unsigned comment added by 142.59.234.16 (talk) 23:41, 1 January 2011 (UTC)

Objective

This article suggests that triage is designed to treat as many patients as possible. This is not true, that effect would be arrived at by treating trivial wounds first. Triage is designed to give the best possible care to those in most urgent need who will benefit from it. It might be worth pointing out that triage is an application of the utility principle, which is part of the philosophical method known as Utilitarianism championed by Jeremy Bentham and J.S. Mill Peter Brooks 13:20, 1st November 2006 (SAST)

"Triage in Canada" relevance?

The 'Triage in Canada' section focuses on a mid-80s implementation of triage in a single hospital in Halifax. This is rather odd, most Canadian hospitals have Triage in their ERs. 207.164.255.110 16:01, 27 August 2007 (UTC)

I've just expanded a bit on Triage in Canada, in order to bring it a little more up to date. I will add new pages on CTAS, METTAG, and a couple of other things, including both surge capacity and surge capability, when I next get a moment. Or for that matter, someone else is more than welcome to take a shot at it. I'll continue to look in. Emrgmgmtca (talk) 16:58, 22 August 2008 (UTC)

Novel

I think the novel Triage is notable enough for it to be mentioned briefly in the text, but there isn't even a disambiguation page. Was noted for its deep examination of PTSS, which has been done to death. Used as a VCE textbook in 2007. Ottre 18:39, 2 February 2009 (UTC)

Ethical Implications

I'm surprised how lightly this article touches the Ethical implications, and when it does its addresses the future implications, not the current ones. —Cliffb (talk) 13:39, 18 June 2009 (UTC)

Reverse Triage

Section seems, at least on the surface, to contradict itself. States that reverse triage involves treating less severe injuries first and then gives the example of cold water drowning victims, where less severe cases would simply not receive treatment, while more severe cases would receive the must urgent care due to the better chance cold water drowning victims have of surviving and recovering (as compared to, say, warm water drowning victims).

Isn't this a case of normal triage, where more severe cases receive treatment priority?

J.M. Archer (talk) 16:40, 15 January 2010 (UTC)

I am not a normal contributor but I question the inclusion of "reverse triage." I have never heard of it. Some institutions triage differently; back in the day military triage dictated that in a combat scenerio cardiac arrest was expectant (dead as disco) where as civilian triage places priority on this. This is not reverse triage. Rather, under specific circumstances there are specific differences. But generally these are exceptions that prove that rule. —Preceding unsigned comment added by 24.148.21.82 (talk) 05:44, 15 March 2010 (UTC)

I have replaced the section in question (which used to say essentially "sometimes less severe cases are treated first", which is what usual triage does). It now refers to a recent proposal to discharge existing non-severe patients to make room for emergency cases in times of crisis. LachlanA (talk) 23:27, 31 August 2014 (UTC)

New start line

How about a new start line?

Triage is bureaucratic method to minimise the financial and administrative costs of medical treatment. —Preceding unsigned comment added by 110.174.23.139 (talk) 07:03, 23 March 2010 (UTC)

Ireland

Is this section about John Carroll vandalism or truth? Either way it's badly written and seems oddly out of place. the_paccagnellan (talk) 09:40, 25 May 2010 (UTC)

This section on Ireland looks like vandalism to me.--86.41.177.50 (talk) 16:37, 27 May 2010 (UTC)

Clarify focus of this triage article

This article is about human, in contrast to non-human triage.

Example reference ...

• Conservationists Use Triage to Determine which Species to Save and Not; Like battlefield medics, conservationists are being forced to explicitly apply triage to determine which creatures to save and which to let go July 23, 2012 Scientific American ... further notability, see Holocene extinction within Planetary boundaries

108.73.113.19 (talk) 02:56, 22 July 2012 (UTC)

That the article is about human triage might be stated, but that reference is an example of the other use, not commenting on it. — Arthur Rubin (talk) 03:30, 22 July 2012 (UTC)

UK NHS: End of Life Care/AMBER admission bundle/Liverpool Care Pathway

You should perhaps add a section on this , as its currently being used to 'triage' the NHS of elderly patients and dementia and alzheimer's sufferers: these do not receive anything but 'palliative care' , and are not admitted to hospital in an emergency,but left at home to 'die naturally' whilst sedated on midazolam and treated for breathlessness or pain with morphine. 79.67.249.149 (talk) 00:40, 20 April 2013 (UTC)twl79.67.249.149 (talk) 00:40, 20 April 2013 (UTC)

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Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 January 2019 and 16 May 2019. Further details are available on the course page. Student editor(s): EricChau. Peer reviewers: Jkgrewal.

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Reverse Triage

This section needs re-writing, reverse triage has multiple meanings and these need explaining here. or a new page formed to explore them all. 213.226.67.38 (talk) 11:09, 16 May 2022 (UTC)