Once a casualty has been triaged it is necessary to ensure that the assigned priority is communicated to further responders to ensure casualties are dealt with in the order of priority and avoid duplication of effort.
Generally, this is achieved by placing a form of labelling onto the casualty and colour coding their priority. To be as effective as possible, triage labels should be highly visible, should use the standard categories (shown in table below) and should be easily and firmly secured to the patient. The label must also allow the casualty’s priority to be altered as their condition changes.
1 – Immediate
Requires lifesaving treatment immediately and has time critical life-threatening injuries
2 – Urgent
Requires significant intervention as soon as possible
Injured or unwell and are unable to walk
3 – Delayed
Requires medical intervention but not with any urgency
Can walk to treatment
Dead (MITT only)
Not breathing (TST only)
Breathing not detected
Ten Second Triage (TST)
Simple labelling that indicates the priority of the casualty should be used as part of the TST process to communicate to further responders and ensure resources are directed appropriately. Keeping a log/tally chart of the number and severity of the casualties that have been triaged also assists in the allocation of resources and communication between emergency services.
Options for labelling include the use of bands colour coded corresponding to the triage category colour. The use of coloured pegs could be considered by non-emergency service first responders as an alternative initial labelling.
Emergency service responders must use a labelling system for TST that incorporates the checked border to distinguish from NHS Major Incident Triage Tool labelling.
Recommendations for triage bands
Size – 300x50mm.
Memory metal core encased within low light fluorescent reflective coloured material (PVC or similar, latex free).
The bands should be flexible so they wrap around a limb (wrist preferred) so they can be pulled straight but snap around a limb if ‘slapped’ against the limb, and can then be straightened again and reused multiple times if required (reuse for training only).
Font – Arial, colours as CMYK shown below.
P1 red band with reflective white checked border and P1 in white font 5 times.
Cyan 0 Magenta 99 Yellow 81 Black 28
P2 yellow band with reflective white checked border and P2 in black font 5 times.
Cyan 2 Magenta 27 Yellow 96 Black 0
P3 green band with reflective white checked border and P3 in white font 5 times.
Cyan 60 Magenta 0 Yellow 100 Black 0
Not Breathing silver band with reflective white checked border and Not Breathing (only the N and B should be uppercase) in black font 3 times.
Cyan 0 Magenta 0 Yellow 0 Black 25
Recommendations for alternative labelling products:
- Must include checked border
- Colours as described in triage band recommendations above
- Be of suitable size to ensure visibility
Whichever labelling methods are chosen, organisations must ensure that they are fit for purpose and clearly understood by partner organisations.
NHS Major Incident Triage Tool (MITT)
NHS Ambulance Services will currently continue to use existing triage labels to label all casualties triaged using MITT.
MITT is differentiated from TST by use of solid colour rather than checked border.
The triage SORT calculation on the reverse of the existing triage labels is now not used, although the clinical information should still be recorded.