The Continuum of Mass Casualty Incident Triage: More Than Colors (Sponsored by the Disaster Medicine Interest Group)

Patient sorting during a mass casualty incident is not a single moment or color-based decision but a dynamic continuum that begins with initial assessment to identify patients requiring lifesaving interventions and continues through repeated reassessments to evaluate response, deterioration, or complications. This process unfolds in a rapidly evolving environment in which patient volume, acuity, and available resources change over time while transportation assets and destination capabilities are coordinated.

In some urban settings, this continuum may progress rapidly; however, in overcrowded urban emergency departments, suburban, rural, frontier, humanitarian, or conflict environments, prolonged on-scene or intermediary care may be required. Emergency departments may also experience sudden self-presentation of large numbers of patients, necessitating real-time triage amid boarding patients, ongoing evaluations, and continued arrivals from emergency medical services.

This session will present a systems-based approach to mass casualty triage that emphasizes decision making, communication, and resource allocation rather than static color categorization. Faculty will discuss how integrating time-dependent data and reassessment improves prioritization of lifesaving interventions and transport decisions. Participants will explore more meaningful performance indicators derived from real-world incidents and simulation to inform planning, benchmarking, and future mass casualty response strategies.