Which tag color according to the disaster triage tag system is assigned to a client who has an immediate threat to life?

Disaster triage nursing review for students about the color-coded tags and the START method!

The goal of this review is to help you understand each of the four tag colors that make up the triage tagging system and how to use the START method to assign tag colors in a disaster situation. For exams, you want to be familiar with the following:

• Meaning of the four tag colors (ex: the colors, who is seen first and so forth, what injury types are included)
• How to apply the START method in scenarios you will be given on an exam (ex: a wounded individual is presenting with the following….what color tag is the wounded assigned using the START method?)

Don’t forget to test your knowledge on this content by taking the disaster triage nursing quiz.

Disaster Triage Nursing Lecture

Disaster Triage Nursing

In this review, we will be concentrating on triage related to a disaster situation. This is where there are many wounded individuals, but the personnel and resources available to treat those wounded are limited. Therefore, personnel and resources should be used wisely, and this is where the disaster color-coded triaging tagging system and START method can be helpful.

Disaster Triage Color Tags

There are four colors and a wounded individual will be tagged one color based on their health status. The four colors include:

To help you keep the meaning of the tag colors red, yellow, and green separated, think of a traffic light and what you do at the traffic light when it turns certain colors. The reason I include this is because many students get confused about these three colors on exams. The black tag color is easy to remember because black is most commonly associated with death, which is the meaning of this tag color.

Red Tag: Immediate

What do you do at a traffic light when it turns red? You stop! Therefore, when a patient is tagged red, STOP and get them treatment because they have first priority in receiving care.

• Seen 1st
• Injuries are life-threatening but they could possibly survive if they are immediately treated.
• Severe alteration in breathing, circulation, and neuro/mental status
• Conditions that would cause a wounded individual to be tagged red (think of conditions or systems of the body that if severely damaged could majorly alter the breathing, circulation, and neuro system)
  • Spinal cord injuries: remember various areas of the spinal cord control breathing, brain and heart function…shock can occur like neurogenic, cardiogenic etc.
  • Severe bleeding (internal or external): if the patient is treated immediately so the bleeding could be stopped and transfused with blood products they may live
  • Major burns that affects a high percentage of the body: burns can affect the circulation and the respiratory system (depending on the burn type and where it’s located)
  • Some types of major respiratory trauma: pneumothorax etc.

Yellow Tag: Delayed

What do you do at a traffic light when it turns yellow? You slow down or delay because you’re about to stop. Therefore, when a patient is tagged yellow their treatment is delayed but for only about an hour or so because they could turn critical based on their presenting injuries.

• Seen 2nd (second priority)
• Significant injuries BUT at this point their breathing, circulation, and mental status is within normal range but this could change.
• Conditions:
  • Bone fractures: major fractures that require medical treatment
  • Integumentary damages: open wounds, deep lacerations etc.

Green Tag: Minor

What do you do at a traffic light when it turns green? You go! Many times these wounded individuals are termed the “walking wounded”. Therefore, these patients can get up and GO (move around). Their injuries are minimal.

• Treatment can be delayed for several hours and some can treat themselves.
• Breathing, circulation, mental status not expected to change

Black Tag: Expectant

• Wounded is dying or expired.
• Injuries are deadly to the point the individual will not survive.
• Absence of breathing, circulation, mental status.

START Method

This method can help determine what tag color a wounded victim is assigned. START stands for “Simple Triage And Rapid Treatment”. This particular method is for the adult. It’s very easy to use and quick.

First, you want to look at the wounded individual and ask yourself “what is the wounded victim doing?” Are they able to walk around? OR Are they unable to walk or move?

If the wounded individual can walk around and move, their breathing, circulation, and mental status are within normal range. Therefore, they are tagged GREEN.

Walking? GREEN TAG

Unable to move or walk? Check these three things in this order: Breathing, Circulation, and Mental Status/Neuro. The wounded individual that cannot walk will be tagged either RED, YELLOW, or BLACK.

Breathing?

• Yes, rate is greater than 30: RED TAG
• Yes, rate is less than 30: check circulation
• No, reposition airway:
  • Still not breathing: BLACK TAG
  • Yes: RED TAG

Circulation? (radial pulse present or less than 2 seconds capillary refill)

• Yes: check mental status
• No: RED TAG

Mental Status? (can they obey your commands?)

• Yes: YELLOW TAG
• No: RED TAG

References:

START Adult Triage. (2019). [Ebook] (p. 1). Retrieved from https://chemm.nlm.nih.gov/StartAdultTriageAlgorithm.pdf

Which tag color according to the disaster triage tag system is assigned to a client who has an immediate threat to life?

6.Which tag color according to the disaster triage tag system is assigned to a clientwho has an immediate threat to life?Correct1Red tag2Black tag3Green tag4Yellow tagAccording to the disaster triage tag system, a red colored tag is used for a client who has an immediate threat to life. A black colored tag is used for a client who is expected to die or is dead. Green colored tagsare used for a client who has minor injuries. A yellow colored tag is used for a client who has major injuries and is requiring immediate treatment.92%of students nationwide answered this question correctly.View Topics13204912741Confidence: Pretty sureStatsIssue with this question?7.oChart/Exhibit 1

The nurse is assessing four clients in the hospital. Which client should the nursecategorize in an emergent level according to the three-tiered triage system?

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Test-Taking Tip: Chart/exhibit items present a situation and ask a question. A variety of objective and subjective information is presented about the client in formats such as the medical record [e.g., laboratorytest results, results of diagnostic procedures, progress notes, healthcare provider orders, medication administration record, health history], physical assessment data, and assistant/client interactions. After analyzing the information presented, the test taker answers the question. These questions usually reflect the analyzing level of cognitive thinking.In a clinical exam, you may be expected to select instruments, arrange instruments, and/or perform some other task. Acquaint yourself with the physical facility. If the required procedures are not clear to you, ask for clarification.92%of students nationwide answered this question correctly.View Topics13204899633Confidence: Pretty sureStatsIssue with this question?

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Índice

• Emergency Triage Color Coding
• How Are Triage Assessments Performed?
• Triage Support Software
• StatusNet911 Software Can Be a Lifesaver During an MCI
• Disaster Triage Nursing Lecture
• Disaster Triage Nursing
• Disaster Triage Color Tags
• START Method

Derived from the French word “trier,” triage means to separate or sort out. This is how triage status works: in a multi-casualty situation, each individual patient undergoes a brief examination by a specially trained EMS provider, who will determine the apparent severity of the injury or illness. A patient who has a potentially life-threatening condition would obviously receive a higher treatment priority than someone with a sprained ankle or broken finger.

Emergency Triage Color Coding

After a triage assessment is completed, a label called a triage tag is placed on the patient. The triage tag identifies the patient and includes information about his or her condition and need for treatment. The triage tag is sometimes color-coded so that a quick glance can give care providers an immediate indication of the triage prioritization. The triage tag is also used to track the patient’s progress through the triage process.

There are four color-coded triage tags that identify the condition and current treatment requirements of the victim:

• Red tag: A red tag indicates the most urgent treatment need. The individual has suffered life-threatening injuries but has a chance for survival if he or she receives immediate medical attention.
• Yellow tag: The individual’s condition is stable and there is no immediate danger of death, although later triage may be necessary. The victim still requires observation and hospitalization.
• Green tag: These victims are referred to as the “walking wounded.” Their injuries are not life-threatening, and they should receive care after those with red or yellow tags.
• White tag: Victims who receive white tags are those who have only minor injuries that do not require further medical treatment.
• Black tags: Used for the deceased and for those whose injuries are so extensive that they will not be able to survive given the care that is available.

How Are Triage Assessments Performed?

When a mass casualty incident occurs, the responsibility to perform a triage assessment typically rests on the shoulders of the emergency responders. The mass casualty triage assessment process can be extremely challenging for multiple reasons. There could be dozens, or even hundreds, of people who need medical attention — many of the injuries are also likely to be of a complex nature. The high degree of chaos and confusion that is normally present at MCI scenes can further complicate the triage process.

Because of the high volume of injuries or illnesses during an MCI, it is imperative that triage is administered as quickly as possible. A basic triage process for patient assessment is S.T.A.R.T., which stands for “simple triage and rapid treatment.” S.T.A.R.T. assessments encompass four areas:

• The patient’s ability to walk and follow basic commands
• Respirations
• Level of circulatory system profusion
• Mental status and alertness

During MCI triage, the victims are generally classified in one of three categories based on their apparent need for medical treatment: immediate, delayed or minor. How long should a triage assessment take? Because of the need to attend to as many individuals as possible in a short amount of time, the entire S.T.A.R.T. assessment should be completed in no more than 30 seconds.

Triage Support Software

Sharing information quickly is vital during a mass casualty incident. StatusNet911 software enables emergency medical personnel to promptly alert destination hospitals about the triage status of every incoming patient. This will allow physicians and nurses to prioritize the treatment needs of each patient and deliver the best possible care upon arrival. The health care facility can also provide timely information about the capacity they can handle for each of the different triage levels.

StatusNet911 Software Can Be a Lifesaver During an MCI

StatusNet911 EMS System Management software from DataTech911 can be an extremely valuable status management tool during an MCI. This user-friendly software solution can provide real-time information to emergency medical personnel regarding triage status. When patients arrive at the hospital or treatment facility, physicians and nurses will be able to provide the best possible care to each individual. StatusNet911 can also be essential for providing timely information to friends and family members regarding the condition of their loved ones.

Learn more about how StatusNet911 can be an invaluable asset during the MCI triage process.

Topics

Medical Author: Melissa Conrad Stoppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

Triage refers to the evaluation and categorization of the sick or wounded when there are insufficient resources for medical care of everyone at once. Historically, triage is believed to have arisen from systems developed for categorization and transport of wounded soldiers on the battlefield. Triage is used in a number of situations in modern medicine, including:

• In mass casualty situations, triage is used to decide who is most urgently in need of transportation to a hospital for care [generally, those who have a chance of survival but who would die without immediate treatment] and whose injuries are less severe and must wait for medical care.

• Triage is also commonly used in crowded emergency rooms and walk-in clinics to determine which patients should be seen and treated immediately.

• Triage may be used to prioritize the use of space or equipment, such as operating rooms, in a crowded medical facility.

In a walk-in clinic or emergency department, an interview with a triage nurse is a common first step to receiving care. He or she generally takes a brief medical history of the complaint and measures vital signs [heart rate, respiratory rate, temperature, and blood pressure] in order to identify seriously ill persons who must receive immediate care.

In a hospital, triage might prevent an operation for an elective facelift from being performed if there are numerous emergent cases requiring use of operating facilities and surgical nursing staff.

In a disaster or mass casualty situation, different systems for triage have been developed. One system is known as START [Simple Triage and Rapid Treatment]. In START, victims are grouped into four categories, depending on the urgency of their need for evacuation. If necessary, START can be implemented by persons without a high level of training. The categories in START are:

• the deceased, who are beyond help

• the injured who could be helped by immediate transportation

• the injured with less severe injuries whose transport can be delayed

• those with minor injuries not requiring urgent care.

Another system that has been used in mass casualty situations is an example of advanced triage implemented by nurses or other skilled personnel. This advanced triage system involves a color-coding scheme using red, yellow, green, white, and black tags:

• Red tags - [immediate] are used to label those who cannot survive without immediate treatment but who have a chance of survival.

• Yellow tags - [observation] for those who require observation [and possible later re-triage]. Their condition is stable for the moment and, they are not in immediate danger of death. These victims will still need hospital care and would be treated immediately under normal circumstances.

• Green tags - [wait] are reserved for the "walking wounded" who will need medical care at some point, after more critical injuries have been treated.

• White tags - [dismiss] are given to those with minor injuries for whom a doctor's care is not required.

• Black tags - [expectant] are used for the deceased and for those whose injuries are so extensive that they will not be able to survive given the care that is available.

Disaster triage nursing review for students about the color-coded tags and the START method!

The goal of this review is to help you understand each of the four tag colors that make up the triage tagging system and how to use the START method to assign tag colors in a disaster situation. For exams, you want to be familiar with the following:

• Meaning of the four tag colors [ex: the colors, who is seen first and so forth, what injury types are included]
• How to apply the START method in scenarios you will be given on an exam [ex: a wounded individual is presenting with the following….what color tag is the wounded assigned using the START method?]

Don’t forget to test your knowledge on this content by taking the disaster triage nursing quiz.

Disaster Triage Nursing Lecture

Disaster Triage Nursing

In this review, we will be concentrating on triage related to a disaster situation. This is where there are many wounded individuals, but the personnel and resources available to treat those wounded are limited. Therefore, personnel and resources should be used wisely, and this is where the disaster color-coded triaging tagging system and START method can be helpful.

There are four colors and a wounded individual will be tagged one color based on their health status. The four colors include:

To help you keep the meaning of the tag colors red, yellow, and green separated, think of a traffic light and what you do at the traffic light when it turns certain colors. The reason I include this is because many students get confused about these three colors on exams. The black tag color is easy to remember because black is most commonly associated with death, which is the meaning of this tag color.

Red Tag: Immediate

What do you do at a traffic light when it turns red? You stop! Therefore, when a patient is tagged red, STOP and get them treatment because they have first priority in receiving care.

• Seen 1st
• Injuries are life-threatening but they could possibly survive if they are immediately treated.
• Severe alteration in breathing, circulation, and neuro/mental status
• Conditions that would cause a wounded individual to be tagged red [think of conditions or systems of the body that if severely damaged could majorly alter the breathing, circulation, and neuro system]
  • Spinal cord injuries: remember various areas of the spinal cord control breathing, brain and heart function…shock can occur like neurogenic, cardiogenic etc.
  • Severe bleeding [internal or external]: if the patient is treated immediately so the bleeding could be stopped and transfused with blood products they may live
  • Major burns that affects a high percentage of the body: burns can affect the circulation and the respiratory system [depending on the burn type and where it’s located]
  • Some types of major respiratory trauma: pneumothorax etc.

Yellow Tag: Delayed

What do you do at a traffic light when it turns yellow? You slow down or delay because you’re about to stop. Therefore, when a patient is tagged yellow their treatment is delayed but for only about an hour or so because they could turn critical based on their presenting injuries.

• Seen 2nd [second priority]
• Significant injuries BUT at this point their breathing, circulation, and mental status is within normal range but this could change.
• Conditions:
  • Bone fractures: major fractures that require medical treatment
  • Integumentary damages: open wounds, deep lacerations etc.

Green Tag: Minor

What do you do at a traffic light when it turns green? You go! Many times these wounded individuals are termed the “walking wounded”. Therefore, these patients can get up and GO [move around]. Their injuries are minimal.

• Treatment can be delayed for several hours and some can treat themselves.
• Breathing, circulation, mental status not expected to change

Black Tag: Expectant

• Wounded is dying or expired.
• Injuries are deadly to the point the individual will not survive.
• Absence of breathing, circulation, mental status.

START Method

This method can help determine what tag color a wounded victim is assigned. START stands for “Simple Triage And Rapid Treatment”. This particular method is for the adult. It’s very easy to use and quick.

First, you want to look at the wounded individual and ask yourself “what is the wounded victim doing?” Are they able to walk around? OR Are they unable to walk or move?

If the wounded individual can walk around and move, their breathing, circulation, and mental status are within normal range. Therefore, they are tagged GREEN.

Walking? GREEN TAG

Unable to move or walk? Check these three things in this order: Breathing, Circulation, and Mental Status/Neuro. The wounded individual that cannot walk will be tagged either RED, YELLOW, or BLACK.

Breathing?

• Yes, rate is greater than 30: RED TAG
• Yes, rate is less than 30: check circulation
• No, reposition airway:
  • Still not breathing: BLACK TAG
  • Yes: RED TAG

Circulation? [radial pulse present or less than 2 seconds capillary refill]

• Yes: check mental status
• No: RED TAG

Mental Status? [can they obey your commands?]

• Yes: YELLOW TAG
• No: RED TAG

References:

START Adult Triage. [2019]. [Ebook] [p. 1]. Retrieved from //chemm.nlm.nih.gov/StartAdultTriageAlgorithm.pdf

RED: [Immediate] severe injuries but high potential for survival with treatment; taken to collection point first. YELLOW: [Delayed] serious injuries but not immediately life-threatening. GREEN: [Walking wounded] minor injuries.

The injured people are placed in four urgent [red], emergency [yellow], delayed [green] and non-salvageable [black] classes.

Category I: Used for viable victims with potentially life-threatening conditions. Category II: Used for victims with non-life-threatening injuries, but who urgently require treatment. Category III: Used for victims with minor injuries that do not require ambulance transport.

Black tags: Used for the deceased and for those whose injuries are so extensive that they will not be able to survive given the care that is available.