Mass-Casualty Incidents: Triage, Tagging and Resource Allocation

Incident Command Roles and Resource Coordination

A mass-casualty incident occurs whenever the total number of patients overwhelms the initial resources available on scene. In everyday emergencies, emergency medical technicians focus all their efforts on one or two individuals at a time. During a mass-casualty incident, however, the operating environment shifts completely. The primary goal of triage in this setting is to do the greatest good for the greatest number of people, which requires strict organizational structure and rapid decision-making.

Clear operational roles ensure that resources are managed effectively. The triage officer is responsible for supervising the initial sorting and prioritization of all casualties across the scene. Incoming resources must also be tightly controlled so that access routes remain clear. The staging officer designates a holding location for incoming apparatus and personnel to prevent traffic congestion. Responding EMS units must report directly to this designated staging area and avoid entering the scene until they are specifically requested.

Once patients are triaged and moved, the treatment officer coordinates patient reassessment and stabilization within designated treatment areas. These areas are typically divided into distinct zones that correspond to the red, yellow, and green triage categories. Meanwhile, the transportation officer communicates with regional receiving facilities to determine hospital bed capacity, tracks which ambulance transports which patient to which destination hospital, and coordinates destinations with receiving facilities and medical direction to avoid overwhelming any one hospital. Because resources are limited, red-tagged patients are allocated transportation priority over yellow-tagged and green-tagged patients.