The major incident triage tool (MITT) shows the recommended priority triage routes depending on incident characteristics. Each has a ‘yes’, which guides you to the next question, or ‘no’ answer which determines priority (P1, P2 and P3) or dead. Clinical instruction is in bold.

Catastrophic bleeding  – Yes – Pressure dressing, tourniquet, haemostatic packing = P1

Walking – Yes = P3

Breathing – No – Open airway if required = Dead. Or in children (under 12 years) who are not breathing. If resources allow, consider 5 rescue breaths if : submersion/immersion/smoke inhalation.

Responds to Voice – No – Place in recovery position = P1

Aged over 2 years – No = P1

Breathing rate 12 – 23 – No =  P1

Heart rate – No = P2

The tool then sets out the METHANE model – which brings structure and clarity to the initial stages of managing any multi-agency or major incident

• M – Major incident
• E – Exact location
• T – Type of incident
• H – Hazardous
• A – Access
• N – Number of casualties
• E – Emergency services

The tool then provides option boxes to number how many patients are in each category of priority – P1, P2 and P3 as well as Dead from 1 to 19.