Triage systems around the world: a historical evolution
Abstract
The process of triaging patients has come a long way. Stemming from the battlefield, it is the ability to sort casualties on the severity of their injuries that has improved the allocation of resources. In modern emergency centres, there is a constant struggle to balance limited resources against the ever-growing patient need. Since the late 1980s, when triage became the mainstream standard for sorting patients, many different systems have developed throughout the world. There was a rise in triage system design as emergency centres became more streamlined and resource-conscious. Countries around the world sought to develop triage systems that would be most effective in their given setting—giving rise to multiple variations of the triage process. This narrative review will explore the evolution of triage systems around the world by presenting: a historical perspective, how and where modern systems developed, what the main characteristics are of different systems, and a discussion of the current state of triage system evolution.
The last three decades have seen a marked increase worldwide in triage system development to meet the needs of our growing patient populations.
This article serves to present and highlight the history of how triage systems have evolved over the years. A narrative review is presented from published literature found on the topic of triage during an unstructured search of medical databases and repositories. The aim was to sift through published research and non-research to piece together an account of how triage systems evolved. A brief historical overview will be presented, as traced back to the first published works on triage, followed by that of more modern developments and common differentiations between systems. Specific triage systems and their evolution around the world will be presented, as found throughout various regions. Systems that focus on paediatricspecific triage will also be identified. Having an appreciation and the knowledge of how triage systems evolved may aid in our understanding of triage systems today, and what the future may hold.
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