SALT Triage is a nationally recognized, standardized method for prioritizing patients in mass casualty incidents (MCIs), ensuring efficient allocation of limited resources to save the greatest number of lives. It is an acronym for Sort, Assess, Life-saving Interventions, Treatment and/or Transport. This guideline was developed as the product of a CDC-sponsored working group, aiming to propose a unified approach to triage based on the best available science and consensus opinion.
The Core Principles of SALT
The fundamental purpose of SALT triage is to provide a consistent and effective framework for emergency responders to quickly evaluate and categorize a large number of casualties. Its design focuses on optimizing patient outcomes during overwhelming events, where traditional one-on-one medical care is impossible. By standardizing the process, SALT helps reduce confusion, improve coordination, and ensure that those with the most urgent, treatable conditions receive immediate attention.
The Five Steps of SALT Triage
The SALT process is sequential and systematic, guiding responders through a series of actions from the initial scene assessment to patient evacuation.
| Step | Description | Key Actions and Goals |
|---|---|---|
| Sort | Rapidly categorize victims into general groups based on their ability to walk or respond, often using a "walking wounded" approach. | - Direct ambulatory victims to a collection point. - Identify immediate threats to life (e.g., severe bleeding, airway obstruction). - Categorize remaining non-ambulatory patients for individual assessment. |
| Assess | Perform a quick, individual assessment of each patient's vital signs and injuries to determine their precise medical needs. | - Check for signs of circulation, breathing, and mental status. - Identify life-threatening injuries. - Assign a preliminary triage category (e.g., immediate, delayed, minimal, expectant). |
| Life-saving Interventions | Provide critical, immediate life-saving interventions that can be performed quickly at the scene and will significantly improve a patient's chance of survival. | - Control severe hemorrhage (e.g., tourniquet application). - Open airway. - Decompress tension pneumothorax (if trained and indicated). - Administer auto-injectors (e.g., for anaphylaxis, nerve agent exposure). |
| Treatment and/or Transport | Based on the assessment and initial interventions, provide further medical care at the scene (treatment) or prepare the patient for transport to a definitive care facility, prioritizing those with the most critical needs. | - Continue ongoing medical care for those awaiting transport. - Coordinate movement of patients to appropriate medical facilities. - Prioritize transport based on triage category (Immediate first, then Delayed, etc.). |
Why is SALT Triage Important?
In the chaos of a mass casualty incident, effective triage is paramount. SALT Triage offers several critical advantages:
- Standardization: It provides a universal language and process, allowing responders from different agencies and jurisdictions to work together seamlessly.
- Efficiency: Its structured approach enables rapid assessment and prioritization of a large number of patients, maximizing lives saved under constrained circumstances.
- Resource Allocation: By clearly categorizing patients, it ensures that limited medical resources (personnel, equipment, transport) are directed to those who will benefit most.
- Improved Outcomes: By focusing on immediate life-saving interventions and rapid transport for critical patients, SALT aims to improve overall survival rates in MCIs.
Who Uses SALT Triage?
SALT Triage is designed for use by a wide range of emergency personnel, including:
- Emergency Medical Services (EMS) providers
- Firefighters
- Law enforcement officers with medical training
- Hospital staff involved in disaster response
- Military medical personnel
Its adoption provides a unified framework for pre-hospital and initial hospital-based triage during large-scale emergencies, from natural disasters to complex terrorist events.
