The red patient is the priority, the black patient cannot be saved. What is medical segregation – trio?

According to the medical segregation system, patients are divided into several groups depending on their prognosis for survival and recovery. The choice is made by a paramedic or a doctor, sometimes they only have a few dozen seconds to make a decision.

  1. Medical segregation (the so-called triage) has been used in medicine for centuries. It allows you to decide which patients should be treated first and which can wait a bit
  2. In Poland, the Start segregation system is usually used, according to which patients are marked with appropriate colors
  3. Medical segregation is used in disasters, accidents involving many people, as well as in hospital emergency departments
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Patient segregation, in accordance with the principles of an appropriate system, is one of the most important tasks of rescuers, doctors and nurses dealing with the treatment of patients in hospital emergency departments, as well as saving people injured in accidents and disasters. The idea is to be able to save and heal as many people as possible. Before a paramedic decides about the patient’s fate, he must check, among others, its temperature, heart rate, breathing pattern, mobility, etc.

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Medical segregation. It started with the Napoleonic era

Medical segregation, i.e. triaż (from the French “triage”, meaning sorting, sorting) is a procedure used in emergency medicine, which allows medical services to divide patients who require help depending on the severity of diseases or injuries.

It is difficult to say when exactly the term triage began to be used to refer to medical activities. The first information on this subject dates back to the Napoleonic times, apparently the segregation was then done by surgeon Dominik Larey. In 1846, British surgeon John Wilson described the principles of segregation in mass accidents. He divided the injuries into minor, serious and fatal. During World War I, the term triage was already commonly used. Wounded soldiers were sent to the segregation points marked in this way, and there the doctor on duty decided about their fate.

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Start system. Four patient colors

Several models of medical segregation are currently used in Poland, the most popular of which is system Start (from English Simple Triage and Rapid Treatment – simple selection and quick help). According to the assumptions, the rescuer has 30 seconds to determine the condition of the injured person. This principle applies primarily to accidents and disasters. The system marks individual groups of patients with colors. There are four groups and four colors: red, yellow, green and black. According to the system:

  1. Red – he is a priority patient, evacuation, medical assistance and transport are his priority. With proper medical care, the patient has a chance to survive and recover;
  2. Yellow – these are patients who have suffered injuries and require medical attention, but the delay in its implementation is not life threatening. Their appropriate treatment should begin no later than the first XNUMX hours after the incident;
  3. Green – these are patients who will survive, regardless of the type of assistance provided;
  4. Black – patients possibly not salvageable in a given situation.

Medical segregation. Which patients have priority?

Segregation also applies to patients in hospital emergency departments (HEDs), which are often overcrowded and it is difficult to treat patients in the right order without the support of the system. Here, segregation should be done by a specially trained person. The most important thing is that first aid is given to those whose lives are in danger. In this case, patients with loss of consciousness, after falls from a height, patients with multi-organ injuries will be classified as red. Bile patients are primarily hemodynamically stable. It is considered that they can wait up to an hour. Green patients are patients, incl. with minor injuries, coughing or pain that is not acute. Such patients will wait the longest – a minimum of two hours.

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