Cerrahpaşa Med J 2023; 47(S1): 9-16 INVITED REVIEW

Triage in Disaster Management

Seda Ozkan , Ibrahim Ikizceli
Department of Emergency Medicine, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Istanbul, Türkiye

Cite this article as: Ozkan S, Ikizceli I. Triage in disaster management. Cerrahpaşa Med J 2023;47(S1):9-16.

Abstract
According to the World Health Organization, a disaster is an ecological phenomenon that is large and sudden enough to require foreign aid. Disaster
disrupts health services in the affected community or region. The use of “disaster triage” in disaster response is considered the cornerstone in the
management of mass injuries. Disaster triage systems allow rapid identification of critical injury without detailed investigation in a complex mass
accident environment. In routine triage, patients with life-threatening and multiple system injuries are treated primarily. In disaster triage, if the num-
ber of injured is higher than the available medical resources, the patients who have a better chance of survival and require less time, material, and
personnel in their intervention are given priority. In this way, secondary disasters are prevented in hospitals; morbidity, complications, and late deaths
are reduced; survival is increased with appropriate treatment; and resources are used appropriately. Disaster triage is divided into 2 as triage applied
in the field and in the hospital. Disaster triage applied in the field has 3 stages. In the first stage, casualties are quickly divided into triage categories
according to their urgency. In the second stage of triage in the field, the injured are re-evaluated in the field, and treatment and referral priorities are
determined. In the third stage of triage in the field, communication-based triage is applied. In this article, it is aimed to explain disaster triage, which
should be applied both in the field and in the hospital environment, and the most commonly used triage systems.
Keywords: Disaster, management, triage

Introduction the individual.8 In addition, it should be as fast as possible, since

Triage is derived from the French word “Trier” and means to clas- the prolongation of the time until the treatment will lead to fatal
sify, to select, or to separate. During the Franco-Russian war under results.7 The patient group that receives a red code in routine tri-
Napoleon Bonaparte, the first triage was conducted by the chief age can be coded in black in case of disaster. Disaster triage is a
surgeon, Baron Dominique Jean Larrey, to save priority soldiers difficult system that looks brutal but has rational rules. Disaster
regardless of rank. With the development of organized medical triage aims to provide treatment and care services to the maxi-
systems, triage has been rapidly developed and started to be used mum number of patients according to available resources by look-
in emergency departments since the early 1900s.1,2 ing at the clinical status of the patients and the prognosis of the
Triage is a method of systematically prioritizing the care and disease. With disaster triage, secondary disasters are prevented in
treatment of patients according to how urgently they need medical hospitals; morbidity, complications, and late deaths are reduced;
care.3 Triage determines whether the patient’s condition is vital, survival is increased with appropriate treatment; and resources are
extremity threatening, and requires immediate treatment to relieve used appropriately.1-3,7
symptoms. In routine triage, patients with life-threatening and mul- The 4 categories of triage commonly used in disasters are6:
tiple system injuries are treated primarily.1-3
According to the World Health Organization, a disaster is • Red (urgent)—lifesaving interventions are required.
an ecological phenomenon that is large and sudden enough to • Yellow (delayed)—immediate lifesaving interventions are
require foreign aid. A disaster is an event that exhausts the ability not required.
of local medical resources to provide comprehensive and defini- • Green (minor)—minimal or patients who do not need medi-
tive medical care in the region where it occurs.4-6 cal care.
Since the resources available in a disaster will not be sufficient • Black—patients who are dead or have little chance of sur-
for all patients, disaster triage has been designed to provide pri- vival despite intensive medical intervention.
ority care for the most urgent and to ensure the survival of the
largest number of injured.7,8 In disaster triage, if the number of In our country, the color coding system accepted by the
injured is higher than the number of rescuers, those who have a International Emergency Medicine Association, which is gener-
higher chance of survival and require less time, material, and per- ally used in the simple triage and rapid treatment (START), North
sonnel for intervention are given priority. Disaster triage uses the Atlantic Treaty Organization (NATO) triage systems, and pre-hos-
categories in the routine triage system. Disaster triage focuses on pital emergency health services, is used in disasters.8,9
ensuring the survival of the community rather than the survival of In this article, it is aimed to explain disaster triage, which should
be applied both in the field and in the hospital environment, and
the most commonly used triage systems.
Received: February 28, 2023 Accepted: March 31, 2023
Publication Date: November 14, 2023 Disaster Triage
Corresponding author: Seda Ozkan, Department of Emergency Medicine, Triage is an essential component of effective disaster manage-
İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Istanbul, ment.10 A disaster triage system must anticipate patients’ needs
Turkey e-mail: Seda.ozkan@iuc.edu.tr
DOI: 10.5152/cjm.2023.23021 for lifesaving interventions and evacuation with both speed and
precision. It should categorize the patients and send them to a

Content of this journal is licensed under a Creative Commons

Attribution-NonCommercial 4.0 International License.
Ozkan and Ikizceli. Disaster Triage

Table 1. Five-Category Triage System in the Field 9 Table 2. Stages of Field Triage in Disaster
Categories Triage in the Field

Red (urgent) Patients who can survive with medical intervention Primary triage In the field, the injured are divided into triage
within minutes or hours categories.
Priority is determined according to emergency
Yellow (delayed) Patients who are serious but do not require treatment needs.
immediate treatment
Secondary Injured in the field are reevaluated.
Green (minor): Patients who do not require significant medical triage Treatment and referral priorities are determined.
intervention
✓ Patients who require hospital-level treatment
Black (dead) Patients who are dead or incompatible with life ✓ Patients requiring treatment in the field
✓ Patients with minor injury
Gray (expectant) Patients who have little chance of survival despite
intensive medical intervention Tertiary triage It is communication-based triage. The following
questions are sought to be answered?
✓ Which patient will go to which hospital?
✓ Will the patient transfer by air or by road?
pre-designed care area in order of priority and ensure that their ✓ Will the ambulance use a light or a siren?
treatment is started appropriately.1,7
Disaster triage systems require rapid identification of critical
injury without detailed investigation in a complex mass accident In cases where the number of patients exceeded transport
environment. In general, triage systems classify patients into 4 or 5 and treatment resources in a short time; “Disaster triage,” which
categories based on their basic physiological criteria. Physiological includes response plans that involve sharing resources, should be
variables used in current triage systems include the assessment of implemented.8 Disaster triage is divided into 2: in the field and in
walking, respiration, circulation, and consciousness.1,2,7,10 the health institution.

Figure 1. Simple triage and rapid treatment triage algorithm.

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 Cerrahpaşa Med J 2023; 47(S1): 9-16

Disaster Triage in the Field gray (expectant) category for hopeless patients with fatal injuries
There are steps of activation, application, mitigation, and (Table 1). Patients in this category can use treatment resources after
recovery in a disaster. Triage is included in the application part of patients who are categorized as more priority.12
disaster and is the initial part of medical management. The triage Triage in the field is carried out in 3 stages (Table 2).
system to be used in the field should be simple and easily applied
in the field. It should not contain a complex scoring system.1 Primary Disaster Triage in the Field
In disasters, field triage is considered the cornerstone of disaster In the field, the injured are divided into triage categories and
response. Disaster triage systems aim to achieve “the best for most priority is determined according to their urgent care needs. There
people.”11 Triage systems applied in disaster require rapid identifi- are many primary triage systems developed for use in disasters in
cation of critical injury without detailed investigation in a complex the world. In this article, the most preferred triage systems will be
mass accident setting.1 mentioned.1,2
Disaster triage systems classify patients into 4 or 5 categories Simple Triage and Rapid Treatment Triage System
based on basic physiological criteria. Physiological variables used The START triage algorithm was first created and used in 1980
in current triage systems include walking, respiration, circulation, by the Newport Beach Fire Department and Hoag Memorial
and consciousness.1,2,7,8,9 In 4 triage systems, patients are catego- Hospital in California.1,2,7 The START is the most common disaster
rized as red (immediate), yellow (delayed), green (minor), and triage system used in many countries including Turkey, the USA,
black (dead or expectant). In 5-triage systems, there is an additional Canada, Australia, Japan, and Israel.1,2,8

Figure 2. Jump simple triage and rapid treatment triage algorithm.

11
Ozkan and Ikizceli. Disaster Triage

In the START triage system, it is aimed to evaluate all injured reevaluated for life-threatening injuries. Second, spontaneous
persons older than 8 years in 60 seconds or less according to the breathing is examined. If the patient is still not breathing after air-
algorithm.2,13 way patency has been established, the patient is coded “expect-
The START triage system evaluates the patient’s walking, respira- ant” and considered unrecoverable. If the patient is breathing, the
tion, perfusion, and consciousness parameters. It divides patients respiratory rate (RR) is checked. If the RR is > 30 per minute, the
into 4 categories with different colors according to these param- patient is considered urgent (red). If RR < 30 per minute, perfusion
eters. Treatable life-threatening injury is coded in red, treatable but is evaluated. Perfusion is assessed by radial pulse or capillary refill.
non-life-threatening injury is coded in yellow, non-serious injury If there is no radial pulse or capillary refill > 2 seconds, the patient
is coded in green, and fatal injury or dead patient is coded in is considered urgent (red). If the patient has a pulse, the state of
black.1,2,7 consciousness is evaluated in the last step. The casualty who can-
While applying START triage, first, patients are asked to walk not obey commands is coded as urgency (red). The injured person
a short distance to a designated place. Patients arriving on foot who obeys the commands is considered as “delayed” with a yel-
are coded in green (with minor injuries). These patients are then low code (Figure 1).1,2,7,8,9

Figure 3. Sort, assess, life-saving interventions, treatment, and/or transport triage algorithm.

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 Cerrahpaşa Med J 2023; 47(S1): 9-16

The START has been criticized as difficult to apply because it the number of casualties.1 The effectiveness of the SALT system has
requires evaluating RR or capillary refill.2,14 Since the capillary been proven to be as good as the Jump START system and its use
refill criterion in dark and cold environments in disasters is not an in pediatric patients has been recommended.15
appropriate reflection of the circulatory system, this criterion was The third step is treatment and/or transport.
removed in the modified model of the triage system (MSTART).2
Radial pulse assessment has been added instead of capillary refill- Sieve Triage System
ing. Some researchers have developed new triage systems (such as Sieve triage is used in parts of Europe, Australia, and the United
Sieve) based on heart rate for circulatory evaluation.1,2,7 Kingdom. It is similar to START triage. The only difference is the
measurement of heart rate in the evaluation of circulation. If the
Jump Simple Triage and Rapid Treatment Triage System for patient’s heart rate is >120 per minute or <40 per minute, the
Pediatric Patients patient is coded in red. If the patient’s heart rate is <120 per min-
The Jump START triage system was developed from the START ute or >40 per minute, it is coded with the yellow triage code.2
triage system for children aged 1-8. Jump START specifically takes
into account the fact that the majority of pediatric arrests are respi- North Atlantic Treaty Organization (Military) Triage System
ratory-related.15 In Jump START, unlike START, the circulation is It was developed for all NATO member countries to use a stan-
evaluated before the “black triage code” is given to the child who dardized triage system in multinational military operations. The
is found to have no breathing. If there is no pulse as a result of main purpose of military triage is to treat more wounded soldiers
the evaluation, the triage code is black. Five rescue breaths are and send them back to the battlefield. In this method, immediate
given to stimulate respiration in children with a peripheral pulse and rapid classification of injured people is made according to
(Figure 2). If breathing starts, the patient’s triage code is red, if not, the type and severity of injury, probability of survival, and priority
the triage code is black. Additionally, the triage code for children of treatment in order to provide the best health care to the largest
who cannot walk starts from yellow.1,8,9 number of people.2,8,16
The codes, meanings, and symbols of the NATO Triage system
Sort, Assess, Life-Saving Interventions, Treatment, and/or are as follows:16
Transport Triage System
The sort, assess, life-saving interventions, treatment, and/or • T1: Unstabil Urgent (Rabbit)
transport (SALT) triage system was developed in 2008 by a work- • T2: Urgent (Tortoise)
ing group of the Centers for Disease Control and Prevention • T3: Non urgent (Pedestrian)
(CDC). The CDC considers SALT the most scientifically designed • T4: Expectant (Cross)
triage system. The SALT is designed for both adult and pediatric
patients.1,14,15 Secondary Disaster Triage in the Field
The SALT divides the injured into 5 categories: dead (already), In cases where the transport of patients from the scene is sig-
expectant (little chance of survival no matter what you do), imme- nificantly prolonged, secondary triage should be performed in the
diate (needs help now), delayed (can wait a while for treatment), field. These situations are the number of injured is high and it is
and minimal (get yourself to the hospital and you will be fine). not possible to transfer all patients to hospitals immediately, roads
These categories are usually color-coded black (dead), red (imme- are closed, the number of ambulances is not sufficient, pre-hospi-
diate), yellow (delayed), and green (minor), respectively.2,7,9,14 tal resources are insufficient, and hospital infrastructures are dam-
The SALT triage system includes 3 steps: (Figure 3) aged.4 The injured who have to stay in the disaster field for a long
The first step is also called general sorting. At this stage, patients time are re-evaluated in the field. Treatment and referral priorities
are asked to walk toward a collection area and act purposefully. are determined.2
Patients are divided into 3 categories according to their responses. When hospitals become unusable in the event of a disaster,
The patients in the first category are those who have life-threaten- field hospitals should be established in predetermined safe areas.
ing injuries and should be evaluated first. The second category is Field hospitals should provide health services to both hospitalized
patients who can only move and need to be evaluated as second- patients and those injured in the disaster.17 However, in the early
ary. The third category is the patient group that can walk indepen- period when hospitals become unusable and field hospitals have
dently and should be evaluated in the third row.1,2,7,9,14 not yet been established, patients and those injured in the disaster
The second step is evaluation and in this step, individual should be transferred to the hospitals in the centers closest to the
evaluation is made. Initially, life-saving interventions (including disaster area. Under these circumstances, the importance of sec-
major bleeding control, airway opening, chest decompression, ondary disaster triage in the field increases.2,4
and autoinjector antidotes) are performed to protect patients’ Secondary triage systems have also been developed to be used
vital signs. If the patient is not breathing after life-saving inter- in this second assessment in the field. Secondary assessment of
ventions, the patient is considered dead. After life-saving inter- victim endpoint (SAVE) and Sort triage systems can be used in the
ventions, if the patient has breathing, consciousness status, secondary evaluation of patients.2
peripheral pulse, respiratory distress, and major bleeding are
checked. If there is a problem in any of these, the patient is Secondary Assessment of Victim Endpoint Triage System
coded in red. If there is minor injury as a result of question- The SAVE triage system aims to categorize patients reflecting the
ing the state of consciousness, peripheral pulse, respiratory dis- balance between resource utilization and probability of survival.
tress, and major bleeding, the patient is coded in green. If the The SAVE triage system uses tools to predict the patient’s clinical
patient has a more serious injury, the patient is coded in yellow status, such as the Glasgow Coma Scale (GCS), Mangled Extremity
(Figure 3).1,2,7,9,14 Severity Score, and postburn survival rate data (Table 3). Once the
The major difference in the SALT system is the expectation cate- patients are evaluated, they are grouped into 1—require hospital-
gory represented using the gray color. Management of the expected level intervention, 2—will significantly benefit from interventions
category is highly dependent on available medical resources and in the field, and 3—survive whether they receive care or not.2,4,18

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Ozkan and Ikizceli. Disaster Triage

Table 3. SAVE Triage System Table 4. Sort Triage System

Mangled • 24.Evaluate GCS

Extremity
Severity Score • 25.GCS + RR+ SBP
Glasgow Coma Score (GCS) Burn İnjury (MESS)
Score 4 3 2 1 0
GCS ≥ 8: it must be treated. Less than 50% MESS ≥ 7: very
The chance of recovery with a chance of high risk of GCS 13-15 9-12 6-8 4-5 3
normal or good neurological survival amputation RR/min ≥30 10-29 6-9 1-5 0
outcome is greater than 50%.
SBP/mmHg ≥90 76-89 50-75 1-49 0
GCS ≤ 7: comfort care only 70% TBSA burn MESS ≤ 7:
attempt limb • 26.Create triage category
salvage
Total score = 12 GREEN
Age ≥ Total score = 11 YELLOW
60 + inhalational Total score = ≤10 RED
injury
GCS, Glasgow coma scale; RR, respiratory rate; SBP, systolic blood
Age ≤ 2 + 50% pressure, min, minute.
TBSA burn

Age ≥ 60 + 35% coded (labeled) according to the score obtained. If the number is
TBSA burn
10 or less, the injured is categorized into the red class, if the num-
Mangled Extremity Severity Score (MESS) ber is equal to 11, the yellow class, and if the number is 12 points,
the patient is categorized into the green class (Table 4).2,18
Skeletal/soft-tissue injury

Low energy (stab; simple fracture; pistol gunshot 1 Tertiary Disaster Triage in the Field
wound) The third stage of disaster triage in the field is communication-
based triage. Answers are sought to the questions of which hospi-
Medium energy (open or multiple fractures, 2 tal the patients will go to, whether they will go by land or air, and
dislocation) whether to use a light or a siren in an ambulance.6,8
High energy (high speed MVA or rifle gunshot 3 The local emergency communications or emergency operations
wound) center should be in contact with hospitals in the affected area. The
total number of casualties, the number of serious injuries (which
Very high energy (high speed trauma + gross 4 may need intensive care unit capacity), and the number of minor
contamination)
injuries should be reported to the emergency contact center and
Limb ischemia hospitals. Hospitals should forward data, such as bed availability,
the number of casualties received so far, and the number of addi-
Pulse reduced or absent but perfusion normal 1* tional casualties the hospital is ready to accept, to their local emer-
Pulseless, paresthesias, diminished capillary refill 2* gency contact center.4 Equal distribution of the injured to hospitals
should be ensured as much as possible. For this, good communica-
Cool, paralyzed, insensate, numb 3* tion should be established between the emergency health services
command in the field and the hospitals.4
Shock

Systolic BP always > 90 mmHg 0 Triage Area

It is the place where patients are classified and triage cards are
Hypotensive transiently 1
inserted and should be set up in the closest and safest place to
Persistent hypotension 2 the scene. The triage responsible person organizes the rescue of
patients in dangerous areas by rescue teams and commands them
Age
according to the latest developments. It evaluates, categorizes and
<30 0 labels life-threatening patients in the most accurate way without
distruping triage. In addition, the person responsible for the tri-
30-50 1 age organizes the work to determine the “danger zone” boundary.
>50 2 The triage supervisor keeps the condition of the patients under
control by performing triage continuously and again. The triage
*Score doubled for ischemia > 6 hours. MESS, Mangled extremity responsible person should be clinically experienced, able to make
severity score; GCS, Glasgow coma scale; TBSA, total body surface quick decisions, be a leader, cool under stress, clear, witty, insight-
area; MVA, motor vehicle accident; BP, blood pressure. ful, problem-solving and creative, knowledgeable about expected
pathologies, and knowing the infrastructure and possibilities of the
Sort Triage System region.19
In the first step in the sort triage system, GCS is determined. In
the second step, the patient’s RR and systolic blood pressure are Triage Cards
measured and categorized. The patient’s GCS, RR, and systolic Triage cards are cards that are colored according to classification
blood pressure values are added. In the third step, patients are (red, yellow, green, black), resistant to the external environment,

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 Cerrahpaşa Med J 2023; 47(S1): 9-16

and designed to be attached to the patient. The injured are marked

with triage cards colored according to the classification. Simple
identification (number, name, gender), information about the
injury, medical interventions applied to the patient, and the time
of application are written on the triage cards. The use of triage
cards during a disaster ensures that patient information is trans-
ferred from the scene to the last health institution to which the
patient is transferred.8,9,20

Triage Errors
It is always possible for errors to occur in triage in disaster chaos.
Over- and under-triage are triage errors. Over-triage occurs when
non-critical patients without life-threatening injuries are assigned
to emergency care. The higher the incidence of patients undergo-
ing over-triage, the more overwhelmed the medical system. Under-
triage occurs when critically injured patients requiring emergency
medical care are assigned to a delayed category. Under-triage
causes delays in medical treatment and also increases mortality Figure 4. Emergency Severity Index Algorithm.
and morbidity.6
The triage problems are listed as follows: Services in Inpatient Health Facilities” (Table 5). According to this
triage system, patients are divided into 3 groups as red, yellow,
• Failure to perform triage correctly. and green.23
• Failure to properly distribute patients to hospitals. Triage in case of disaster has to be different from routine emer-
• Sending patients to the same hospital all the time even gency department triage. Disaster triage starts to be applied in case
though there is no place. of sudden development of incidents in mass injuries and inad-
• Failure to follow the trace of the sent patient. equacy of health resources. In this case, the injured, who have a
• Failure to keep accurate or sufficient records. better chance of surviving, require less time, less material, and less
• Early transfer: transporting the patient to the hospital before personnel, are treated with priority.21
the completion of the triage assessments after the emergency In case of disaster, it would be most appropriate to make a 5-tri-
care. age system by adding gray and black areas to the triple system rec-
• Under-triage: It is the mistaken evaluation of patients at a ommended by the Ministry of Health in the hospital triage system
low level of urgency, even though it is critical and requires (Table 6). In this way, the possibilities at hand will be used more
urgent medical intervention. appropriately.12
• Over-triage: Referring non-critical patients to the critical
aspect area. Conclusion
The application, reliability, sensitivity, and specificity of triage
Disaster Triage in Hospital systems developed for use in disasters are verified by simulations.
In routine emergency department triage, patients with life- However, the correct use of triage systems and their success rates
threatening and multiple system injuries are treated first. In the may differ in the real chaotic environment of a disaster. A sim-
emergency department triage in disaster situations, on the other ple triage system that quickly identifies critical injuries without
hand, if the number of injured is higher than the number of rescu- detailed investigation would be easy to implement in a disaster.
ers, the injured who have a better chance of survival and whose
intervention requires less time, material, and personnel are given Table 5. Routine Emergency Department Triage Used in Türkiye
priority.1,2
The Emergency Severity Index (ESI), published by the American Red area
Association of Emergency Nurses and recommended by the Category 1 Life-threatening conditions that require a rapid
American Association of Emergency Physicians, is widely used in aggressive approach, urgent simultaneous assessment,
routine emergency triage. This triage system is a 5-triage system and treatment
and is categorized according to the resource requirement to be
used (Figure 4). According to this triage system, category 1 rep- Category 2 It includes situations that are highly life-threatening
and need to be evaluated and treated within 10
resents the most urgent patient group, and category 5 represents
minutes.
the least urgent patient group.21 The resources accepted during the
application of the ESI triage system are laboratory, electrocardi- Yellow area
ography, direct radiography, ultrasound, computed tomography,
Category 1 Includes potentially life-threatening conditions, risk of
magnetic resonance imaging, angiography, intravenous fluids,
limb loss, and significant morbidity.
injection, nebula, expert consultation, and simple interventions.
During the application of the ESI triage system, anamnesis, physi- Category 2 Includes conditions with intermediate and prolonged
cal examination, initiation of saline or heparin, giving oral therapy, symptoms and potential for seriousness.
tetanus immunization, prescribing, telephone consultation, dress-
Green area
ing, and splint applications are not considered as resources.22
In Türkiye, as routine emergency triage, a triple triage system has Outpatients are patients who are stable in general condition and
been applied since 2009 in accordance with the “Communiqué have simple health problems that can be treated on an outpatient basis.
on Implementation Procedures and Principles of Emergency

15
Ozkan and Ikizceli. Disaster Triage

Table 6. Hospital Triage Zones in Disaster

Red zone ✓ It is the area where patients with life-threatening injuries are intervened.
✓ It should be installed close to the operating room and intensive care units.
✓ There should be doctors and auxiliary health personnel who can provide emergency intervention and treatment.
✓ The “Trauma Team” should work effectively in this area.

Yellow zone ✓ Patients evaluated in this region are severely injured, but they can hemodynamically tolerate some delays in interventions.
✓ The trauma team left over from the red zone and the doctors of other branches should work in the yellow zone.

Green zone ✓ Patients who can walk and do not need emergency intervention are evaluated.
✓ After the initial assessment/intervention, patients can be sent to other centers or to their homes.
✓ Less-experienced physicians may be assigned to the green zone.

Gray zone ✓ It is the area where patients with no life expectancy are followed and their analgesia is performed.
✓ Nurses and other assistant health personnel may work.

Black zone ✓ Patients who came to the hospital as dead or died in the hospital are in this zone.
✓ Forensic Medicine Specialists, Pathology specialists, and morgue officers can work in this zone.

As a result, “triage” in disasters is considered the cornerstone of 8. Gündüz A. Afet Tıbbı; 2023. Available from: https://www.ktu.edu.tr/
disaster response. Suggested triage systems should be learned and dosyalar/afettibbi_8d344.pdf.
9. Özüçelik DN. Afetlerde triaj. Özüçelik DN, Çev. Afetlerde Acil Tıp
used in disaster situations in order to quickly recognize critical Hizmetleri. 1. Baskı. Ankara: Türkiye Klinikleri; 2019:32-39.
injuries in disasters and to provide care to the maximum number of 10. Garner A, Lee A, Harrison K, Schultz CH. Comparative analysis of
patients who will benefit, taking into account available resources. multiple-casualty incident triage algorithms. Ann Emerg Med.
2001;38(5):541-548. [CrossRef]
11. Ryan K, George D, Liu J, Mitchell P, Nelson K, Kue R. The use of
Peer-review: Externally peer-reviewed. field triage in disaster and mass casualty incidents: a survey of current
practices by EMS personnel. Prehosp Emerg Care. 2018;22(4):520-
526. [CrossRef]
Author Contributions: Concept – S.O., I.I.; Design – S.O.; Supervision – I.I.; 12. How to use SALT to triage MCI patients. https://www.ems1.com/mass
Resources – S.O.; Materials – S.O.; Data Collection and/or Processing – -casualty-incidents-mci/articles/how-to-use-salt-to-triage-mci-patient
S.O., I.I.; Analysis and/or Interpretation – I.I.; Literature Search – S.O.; Writ- s-ioh8pD88282FDTdy/. Accessed February 22, 2023.
ing Manuscript – S.O., I.I.; Critical Review – I.I.; Other – S.O. 13. Bhalla MC, Frey J, Rider C, Nord M, Hegerhorst M. Simple triage
algorithm and rapid treatment and sort, assess, lifesaving, interven-
tions, treatment, and transportation mass casualty triage methods for
Declaration of Interests: The authors have no conflict of interest to declare. sensitivity, specificity, and predictive values. Am J Emerg Med.
2015;33(11):1687-1691. [CrossRef]
Funding: The authors declared that this study has received no financial 14. START, SALT, and RAMP triage in a mass casualty event. https://ww
support. w.cri sis-m edici ne.co m/sta rt-sa lt-an d-ram p-tri age-i n-a-m ass-c asual
ty-event/. Accessed March 23, 2023.
15. Jones N, White ML, Tofil N, et al. Randomized trial comparing two
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