Emaduddin Siddiqui.
Emergency triage: extend of our knowledge.
J Pak Med Assoc Jan ;62(8):839-42.

Triage is derived from the French word TIER, "to sort/separate or select". A process of determining the severity of patients and prioritizing them according to their medical urgency, initially used to sort agricultural products, during disaster, in the battle field and even on telephonic advice, however presently it is exclusively used in specific health care context1 like hospital EDs (emergency department), and in ambulatory medical services. Dominique Jean Larrey, was the first to own most of the triage ideas during the Napoleonic Wars. Triage was then formalized during World War I to treat the injured solders in battlefields. Historically, there has been a broad range of attempts to triage patients, and differing approaches and patient tagging systems were used in different countries. Since the last century, triage is modified with scientific and modern approaches and more logically dependent on physiological needs and assessment findings of patients. Assess, Categorization/transport are the bases of all triage.2 Different types of triage are functional at present i.e. "Simple triage", used at the scene of a mass-casualty, to sort patients who need critical attention and continuous integrated triage, it has 3 subtypes. Other types are: "Group (Global) Triage (e.g.; M.A.S.S. triage)", when Medical disaster overwhelms the ability of a given area or community to meet a demand for health care. "Individual Triage. e.g. S.T.A.R.T. (Simple Triage and Rapid Treatment)", process of first responders to effectively and efficiently evaluate all of the victims during a mass casualty incident. Developed in 1983 by Newport Beach Fire Department, California.and Hospital Triage (e.g. E.S.I. or Emergency Severity Index v 4.0)3 this is based on visual assessment, person perception and predicted resources used. Advanced Triage", resource dependent, triage staff may decide to divert the present resources to a more stable patient, having more chance of survival with little or existing resources. This has significant ethical implications, thus confined to serious disaster and battle field.3 "Reverse triage", Modern hospital triage based on appropriate use of ED space and resources to ensure that all patients presenting to the ED shall have access to care according to their respective needs.

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