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 Release 22.0, Sept. 2008
 
Chapter : ch29. Trauma & Emergency Medicine Section : Triage of the Trauma Patient
  Categories of Llewellyn for Military Triage

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Overview :

Llewellyn described the simplified triage used by the military in combat conditions. The nature of triage in combat often differs from that seen in civilian situations. The author is from the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

 

Features

Triage Category

ambulatory with superficial wounds that can be treated in the field

minimal

requires field treatment with evacuation to field or base hospital

serious

dying with injuries incompatible with life despite maximal therapy; surgery futile (hopelessly wounded)

expectant

 

 

Serious Casualties

Triage Category

life-threatening injuries requiring resuscitation and a life-saving procedure immediately on arrival; after initial care patient may undergo further surgery or be triaged to a less serious category

urgent

life-threatening injuries that require surgery within 2 hours of arrival at the hospital; temporarily stable while being evaluated and prepared for surgery

immediate

wounds not immediately life-threatening; a delay in surgery will not compromise care

delayed

 

where:

• A serious-delayed patient might be viewed as moderate to severe.

 

Features of military triage:

(1) frequently mass casualty events, with inflow coming in waves

(2) most soldiers are relatively young and healthy, without chronic comorbid conditions and without intoxication

(3) many soldiers suffer from exposure, dehydration, exhaustion, sleep deprivation, and poor nutrition

(4) wounds in modern combat are often multiple and diverse in nature (burns, blast, complex munitions, crush, blunt, chemical) with environmental contamination

(5) evacuation may be delayed

(6) litigation is not a primary concern

 

  References:

Llewellyn CH. Triage: In austere environments and echeloned medical systems. World J Surg. 1992; 16: 904-909.

 

 

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