Milmed Scientific_South African Military Medicine Periodical_Feb 2011

Wednesday, September 22 2021



Grobler, RC., & van Aswegen, PJ. (2011). Triage in the Combat Scenario as a Tool for the Optimal Treatment and Evacuation of the Wounded Soldier. Milmed Scientific 3(1),39-54. Retrieved from:



Deciding which patient to treat first when more than one patient requires medical treatment is a decision that must be made on scientific grounds. The use of evidence-based triage protocols could significantly help medical personnel in making the decision.


Patients are prioritised into categories according to the life or limb threatening level of their injuries. The higher the category, the more severe the injuries and the more urgent the medical treatment required.


Triage SIEVE is a model based on the mobility and ABC (Airway, Breathing and Circulation) presentation of the patient. This model is used to perform initial / primary triage and is presented in an easy-to-follow algorithm.


Triage SORT takes into consideration anatomical and physiological parameters of the patient. Clinical knowledge and experience are important in the interpretation of the patient’s presenting signs and symptoms in order to make a decision.


On the battlefield, reversed triage may be used. In this scenario, the patients with minor injuries are treated before patients with more serious injuries in order to return them to the battlefield.



Triage was initially developed by Dominique Jean Larrey (1,5), a surgeon during the Napoleonic Wars (1803-1815). He realised that casualties must be sorted into priorities of care to optimise care without taking their military rank into consideration. His objective was however to treat the less injured first to get them back to battle as soon as possible.


Triage existed in the past but only informally. It was only during World War I (5) (1914 – 1918)that formalised triage was initiated by French doctors who were treating the wounded on the battlefield as well as at the aid stations behind the front.