Mass casualty incidents (MCIs) challenge the capacity and adaptability of civilian healthcare systems. In military settings, battlefield triage systems have evolved to rapidly and effectively sort and prioritize casualties under austere and high-pressure environments. Bridging the knowledge, skills, and practices from battlefield triage into civilian settings can potentially improve outcomes during MCIs. This systematic review examines how battlefield triage tactics have been or could be incorporated into civilian healthcare responses and evaluates their effectiveness, feasibility, and implementation barriers.
Triage is the cornerstone of effective mass casualty management. While civilian triage systems like START and SALT are commonly used in the U.S., military triage approaches offer a more dynamic and adaptable model. The U.S. military’s experiences in Iraq and Afghanistan have refined triage strategies such as Tactical Combat Casualty Care (TCCC) and the MIST (Mechanism, Injuries, Signs, Treatments) report format. Civilian healthcare providers can benefit from these models, particularly in settings where surge capacity and resource allocation are limited.
However, systematic evidence on the translation and adaptation of battlefield triage to civilian settings remains fragmented. This review aims to consolidate the existing research, explore comparative effectiveness, and assess the real-world barriers to integration.
Primary Objective: To systematically review and analyze existing literature on the incorporation of battlefield triage practices into civilian healthcare during mass casualty events.
Study Questions:
- What specific battlefield triage methods have demonstrated improved patient outcomes during mass casualty incidents, and how do they compare to current civilian triage protocols?
- What are the barriers and facilitators to implementing battlefield triage techniques within civilian healthcare systems during MCIs?
- How has the adoption or adaptation of military triage strategies in past civilian mass casualty events impacted response times, resource allocation, and survival rates?