Clinical guidelines for major incidents and mass casualty events

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TheĀ guidance has been developed following a period of multiple incidents which have presented a range of challenging clinical scenarios such as blast injury, penetrating injury and the use of chemical agents, unlike those seen in day-to-day practice.

As part of a review of major incident triage undertaken by the NHS England Emergency Preparedness, Resilience and Response (EPRR) Clinical Reference Group (CRG) two new triage tools have been developed; the NHS Major Incident Triage Tool (MITT) and the Ten Second Triage Tool (TST).

This information can be made available in alternative formats, such as easy read or large print, and may be available in alternative languages, upon request. Please contact National EPRR team on england.eprr@nhs.net.

Clinical guidelines for major incidents and mass casualty events

Summary

Version 2, updated September 2020.

Letters to ambulance service and acute trust chief executive officers (CEOs)

Link

Summary

Published 19 April 2023.

Link

Summary

Published 19 April 2023.

NHS Major Incident Triage tool (MITT)

Link

Summary

Accessible version.

The MITT is to be used by all NHS responders to major incidents and is a single tool for both adult and paediatric patients that allows for rapid, reliable and reproducible triage.

MITT replaces the current triage sieve tool, triage sort tool and the paediatric triage tape.

Summary

PDF version.

Summary

This presentation explains how the Major Incident Triage Tool (MITT) works. The MITT is designed to be used as part of the NHS clinical response to a major incident.

See also the MITT presentation supporting information.

Ten Second Triage tool (TST)

Link

Summary

Accessible version.

The TST is designed to be quick, simple and effective at prioritising large numbers of casualties rapidly with a focus on immediately providing lifesaving interventions (LSI). These LSI include control of severe bleeding and opening of the airway, which are known to be the key requirements to maximise patient survival in the early stages of injury. Whilst principally designed for events where casualty numbers far outweigh the availability of responders it is equally effective at any multiple patient event.

Document

Summary

PDF version.

Link

Summary

This document explains the principles of labelling of patients following triage to communicate the prioritisation of large numbers of casualties.

Media

  • Running time: 00:06:36

Summary

This video explains how Ten Second Triage (TST) works and supports the training for first responders, including fire and police, to use this tool. Following initial triage using TST, the MITT tool will be used once NHS clinicians arrive if required.

Media

  • Running time: 00:10:46

Summary

This video explains how both the Ten Second Triage (TST) and the Major Incident Triage Tool (MITT) work and supports the training for first responders, including fire and police, as well as NHS clinicians. Following initial triage using TST, the MITT tool will be used once NHS clinicians arrive if required.

Summary

This presentation explains how the Ten Second Triage (TST) works and supports training for non-clinical responders, including fire and police, to use this tool. Following initial triage using TST, the MITT tool will be used once NHS clinicians arrive if required.