Pre-hospital triage: The national perspective

Triage in emergency medicine describes the process of categorising patients on the basis of urgency. Triage of patients is of importance in three main areas; firstly as a component of primary assessment to guide the treatment of individual patients, secondly as a basis for individual allocation of resources and finally as a case mix description of patient groups. In the pre-hospital environment the first and second of these are of most concern. Ambulance officers are faced with deciding how much treatment is offered to the patient in the pre-hospital area, and the effects of treatment in the field on outcome, both good and bad. Vital decisions are often required, in the knowledge that the time required to apply that treatment must be balanced against the delay in accessing advanced care. The ambulance officer is also confronted with choices to be made regarding the source of medical care most appropriate to the patient in the circumstances. This paper reviews the concepts of triage as it applies to pre-hospital care, the current status of triage models used in the pre-hospital environment both internationally and in Australia and finally presents a plea for consistency based on scientific grounds both within the pre-hospital environment and the hospital system