For years, the SMART triage system has been the standard in mass casualty incident (MCI) response, offering a structured framework to manage patient prioritisation in chaotic environments. While it has been effective in many scenarios, it is not without limitations. The recent inquiry into the Manchester Arena bombing brought a number of shortcomings to light. One of the outcomes of this inquiry was the development of the Ten Second Triage (TST) system. Unlike legacy Major Incident Triage systems, an improvement in the TST is its ability to account for the potential of patient deterioration. This gap has previously led to under-triaged patients, reducing the ability of past systems to identify those who need immediate intervention.
Furthermore, the SMART system’s reliance on longer assessment periods during the initial sieve process delayes the overall triage process. While sieving and sorting patients remains crucial to any MCI response, it is clear that the initial triage process needed optimisation—a need now met by the TST system.
How Ten Second Triage Revolutionises Initial Assessment
The Ten Second Triage system streamlines the initial triage process, allowing responders to quickly and accurately identify critical patients who require immediate care, based on respiratory status, circulatory status, consciousness, major bleed and pattern of injury. TST introduces a significant improvement by incorporating recognition of penetrating injuries within the "deadly box"—the neck, axilla, and down to the umbilicus. These injuries, often associated with massive hemorrhaging or internal damage, are now classified as Priority One (Red), ensuring they are treated with the urgency they demand.
This dynamic approach addresses the SMART system's blind spots, ensuring patients at risk of rapid deterioration are no longer overlooked. In doing so, TST not only reduces triage time but also increases the accuracy of prioritising patients in life-threatening conditions.
The Role of Our Major Incident Clinical Aide
To support Australia's transition to using Ten Second Triage, our Major Incident Clinical Aide has been designed to follow the TST algorithm. This tool is instrumental in guiding responders through the optimised triage process, ensuring they can quickly identify patients with life-threatening injuries. Key features include:
- Rapid, evidence-based triage guidance, reducing decision-making time.
- Prioritization of penetrating injuries to the deadly box, reflecting the risk of deterioration.
- Seamless integration into emergency response protocols, empowering teams to respond effectively.
By combining the Ten Second Triage system with our Clinical Aide, emergency responders are equipped to save lives more efficiently and confidently.
The Future of Emergency Triage
The Ten Second Triage system represents a leap forward in MCI response, addressing the limitations of the SMART system and setting a new standard for initial patient assessment. With its focus on recognising the potential for deterioration and expediting critical decisions, TST ensures no injury is underestimated. When paired with innovative tools like our Major Incident Clinical Aide, this system promises a future where triage is faster, smarter, and life-saving.
As we continue to adapt and innovate, one thing remains certain: optimising emergency response is not just about improving processes—it’s about making every second count.