Page 88 - ATP-P 11th Ed

Table 21 Triage Assessment
Each Patient Triage Assessment Should Be Complete in Less Than 60 Seconds
SECTION 1 Category I: Immediate • (Any MARCH issue) Examples
Category
• Massive hemorrhage
• 20–70% Burns
(red chemlite)
• Airway obstruction
• Unstable Vital Signs
• Flail/open chest wound
• Tension-Pneumothorax/hemothorax • Severe TBI (unconscious alive Pt)
Category II: Delayed • Open fractures with PMS intact • Moderate TBI (stable vital signs)
(green chemlite) • Soft tissue injuries • Open abdominal wounds
*Category III: Minimal • Minor abrasions, burns, sprains • Fractures/dislocations with PMS
(no chemlite) remain lacerations • Mild TBI
armed continue to engage • Moderate/Mild anxiety
**Category IV: • Massive head or spinal • Third degree burns >70% BSA
Expectant or Hero injury • Injuries incompatible with life
(blue chemlite)
*In combat, it is assumed that minimals will continue to stay armed/engaged if no mental status altering pharma-
ceuticals are given for pain.
**Expectant category is ONLY used in combat operations and/or when the requirements to adequately treat these
patients exceed the available resources. In peacetime, it is generally assumed that all patients have a chance of
survival.
Source: Special Operations Force Medic Handbooks (PJ, Ranger)
Triage Class 1 (MASCAL)
Adequate medics to treat critical patients and handle the rest
a. Many casualties
b. Threat controlled
c. Resources not severely limited
d. Medical personnel can arrive
e. Evacuation possible
Table 22 Triage Class 1 Actions and Goals
<1 Hour After Injury 1–4 Hours After Injury >4 Hours After Injury
Goals Goals Goals
• Eliminate Threat • DCR/DCS as soon as • Evacuate
• Establish CCP possible
• Blood transfusion within • Use advanced resuscitation to
30 minutes “extend the Golden Hour”
• Evacuate to DCR/DCS
within 1 hour
Actions Actions Actions
• Stop external bleeding • MARCH PAWS • Use prolonged care to
• Clear airway • Transfuse optimize outcomes
• Ensure ventilation
• Formal triage
• Transfuse

78 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 79