Australian disaster triage: A colour maze in the tower of babel

Background: The objective of this study was to review the systems of disast er triage used by Australian State and Territory ambulance services and com pare their triage taxonomy, methodology and documentation with the Australi an Council on Health Care Standard's (ACHCS) National Triage Scale, which i s used in all Australian hospital emergency departments. Methods: A postal survey of the State and Territory ambulance services duri ng October 1996 was conducted. Details of the mass casualty incident (MCI) triage systems were then compared with the ACHCS National Triage Scale. Col ours specified or used on a triage tag were checked for compliance with Sta ndards Australia AS-2700 1996 Colour Standards for General Purposes. Partic ipants consisted of those State and Territory ambulance services which woul d be the initial emergency medical service responders in the event of an MC I in an Australian capital city, and the ACHCS. The main outcome measure wa s the homology between the respective triage taxonomies, methodologies and documentation systems. Results: All eight State and Territory ambulance services used a numerical and colour coded system to indicate triage priority during an MCI. There we re five different triage tag designs for triage documentation, six differen t triage taxonomies and five different triage methodologies with minimal ho mology between the different triage systems and the National Triage Scale u sed in hospitals. Only two ambulance triage systems specifically triaged em otional disturbance. Several triage tags and their patient attachments were made from perishable materials and are thus likely to fail under field con ditions. Conclusion: The multiplicity of triage systems used within Australia will r esult in avoidable confusion, thus hindering the medical response to an MCI , especially for incidents near State or Territory borders. There is little evidence to support the continued use of triage tags. Australia needs to d evelop a uniform system of patient triage as a national priority.