An Australian mass casualty incident triage system for the future based upon triage mistakes of the past: The Homebush Triage Standard

Background: The purpose of this study was to create a system of mass casual ty incident triage that provides a common language platform for both ambula nce and hospital personnel based upon standard daily operating procedures f or both groups. Methods: An annotated literature review was conducted. Results: The Homebush Triage Standard taxonomy consists of five categories: immediate, urgent, not urgent, dying and dead, which are given the phoneti c alphabet designations of Alpha, Brave, Charlie, Delta and Echo, respectiv ely, to facilitate radio voice communications. Colours are assigned to each category: red (Homebush Red), yellow (Homebush Gold), green (Homebush Gree n), white and black comply with Standards Australia AS-2700 1996 Colour Sta ndard for General Purposes, to ensure triage materials have consistent prod uction standards. Numbers are reserved to either quantify or stratify indiv iduals within a particular triage category. The Homebush Triage Standard me thodology is based on START (Simple Triage Assessment and Rapid Transport) and SAVE (Secondary Assessment of Victim Endpoint) and documents triage pri ority using geographic triage with triage flags, instead of triage tags. Conclusion: The Homebush Triage Standard provides a basis for both seamless patient reassessment at all points along the casualty evacuation chain and the audit of the medical response to mass casualty incidents. It allows ho spital and ambulance staff to keep working using familiar routines and remo ves fundamental barriers to good communication during a time of crisis.