Going vertical: triage flags improve extraction times for priority patients

OBJECTIVE: The number of mass casualty incidents (MCIs) has been steadily increasing. High‐priority MCI patient outcomes are highly dependent on rapid identification, treatment, and transport. Although there are several methods used to mark patients for rapid extraction, most current methods utilize low‐profile tags, with no gold standard. This study examines if the use of a vertical cue, a triage flag, to identify high priority MCI patients results in faster extraction times than those with a wrist triage tag alone. METHODS: A prospective randomized crossover study was conducted with medical students trained in basic disaster life support, who completed 2 extraction simulations. Two fields were each arranged with 32 randomly placed, pretriaged manikins (10 red, 17 yellow, 5 black). The manikins were marked with either triage tags alone or with triage tags and flags. The total time elapsed for participants to report all high‐priority manikin triage tag numbers was recorded. RESULTS: Eighty‐two participants completed both simulations. The average completion time for the “tags‐only” simulation was 94.5 seconds (±16.4 seconds) compared to 70.7 seconds (±13.2 seconds) for the flags and tags simulation. This corresponds to an average decrease of 23.8 seconds (P < 0.0001), or a 25.2% reduction in time. CONCLUSION: Using a vertical cue decreased the time required to identify high‐priority patients. This suggests that a rapidly deployable and visually apparent triage marker may allow faster identification and extraction of patients across a field of victims with varying injury severities than a flat horizontal triage tag, thereby potentially improving patient outcomes.