Triage is the process of rapidly sorting patients based on their need for immediate medical treatment when resources are strained, such as during a mass casualty incident (MCI). This sorting ensures that the greatest number of people receive the most benefit from the limited available resources. Disaster planning requires a rapid method to categorize the injured quickly and effectively. A standardized color-coding system serves this purpose by providing a clear, immediate visual marker of a patient’s medical priority.
The Purpose of Triage Color Coding
Color coding provides a method for rapid assessment and communication that bypasses the need for detailed paperwork or verbal reports in a chaotic environment. The use of highly visible colors, often displayed on triage tags secured to the patient, simplifies a complex medical decision into an easily recognizable signal. This allows first responders to immediately understand the urgency of a patient’s condition. The colors guide the efficient allocation of limited resources, directing personnel to the patients who need life-saving interventions first. This prioritization maximizes the number of survivors in a disaster scenario.
The Standard Triage Color Categories
Organizational disaster plans use four primary colors, each representing a distinct level of medical priority and required action.
Red (Immediate)
The highest priority is designated by Red, which signifies an Immediate category. These patients have life-threatening injuries, such as severe shock or uncontrolled hemorrhage, but they have a high probability of survival if they receive medical intervention right away. They are the first to be transported and treated, as a delay would likely result in death.
Yellow (Delayed)
The next priority level is indicated by Yellow, which represents the Delayed category. These individuals have serious, potentially significant injuries, such as major fractures or stable abdominal injuries, but their immediate survival is not dependent on rapid intervention. They are considered stable enough to wait for care, often for several hours, until all Red-tagged patients have been addressed. Their condition must be monitored closely for any deterioration.
Green (Minor)
The third category is marked by Green, classifying patients as Minor or the “walking wounded.” These patients have injuries that are less severe, such as minor cuts, abrasions, or sprains. They can manage their care or wait for treatment until all higher-priority patients have been seen. They are often asked to move to a designated safe area, which helps first responders quickly identify the non-ambulatory patients.
Black (Expectant or Deceased)
The final color is Black, which is assigned to the Expectant or Deceased category. This includes patients who are deceased, or whose injuries are so overwhelming that, given the limited resources of a mass casualty event, their survival is considered unlikely. This designation ensures that limited medical resources are focused on those patients who have the highest chance of survival.
Common Triage Systems Utilizing Color Codes
The standard color categories are applied across several widely adopted triage methodologies used by emergency medical services. The Simple Triage and Rapid Treatment (START) method is the most common protocol used for adults in a disaster setting. This system uses a rapid, 60-second assessment of a patient’s respiration, perfusion, and mental status (RPM) to assign one of the four color codes. For pediatric patients, a modified version called JumpSTART adapts the physiological parameters to account for differences in a child’s normal vital signs. Both START and JumpSTART ensure that the resulting color—Red, Yellow, Green, or Black—has the same universal meaning for priority and required action, allowing efficient patient management.