June 04, 2010 01:35am EST 

The process of triage determines a patient’s priority in the mind of physicians, particularly as it relates to patient treatment. It is necessary to ration patient treatment, especially when hospital resources are insufficient for all to be treated immediately. Based on the severity of their condition, patients in the emergency room may experience a difference in the order of emergency treatment. Additionally, triage may determine where a patient is kept or sent.
A patient will have his or her own opinion about their right to receive medical treatment, but in cases of mass casualties or serious injury, the hospital physician’s final decision about whether to provide treatment to the patient is what will make the difference. A system is always necessary for an institution function as it desires. While there are obvious ethical implications in triage, for an emergency room to function correctly, it must have a system. In the end, triage is necessary for a hospital emergency room to work efficiently and treat all of its patients in the most effective way.
In the past, triage was much more primitive. It was often simplified into three basic categories: those who were likely to live, those who were likely to die, and those whose life may depend on medical care. This system of triage still applies today, however, apart from hospitals’ triage systems. For example, in emergency medical services systems, an overabundance of patients may cause paramedics to use the above model. There is no doubt that instinct plays a large part in the effectiveness of emergency medical services.
Conversely, triage in the emergency room usually follows two types of triage — simple triage and advanced triage.
Simple Triage: Simple triage is used primarily in a mass-casualty incident, an incident which emergency room medical services are overwhelmed by casualties, and is used to sort patients into two categories: those who need critical attention and those with less serious injuries. Patients are categorized and often flagged with printed triage tags to distinguish one category from the other.
The S.T.A.R.T model of triage is a simple system that is easily performed by hospital emergency personnel in emergency room situations. It has been field-proven for mass casualty incidents such as public transportation accidents and natural disasters. In the S.T.A.R.T. model, hospital emergency rooms separated patients into four different groups:
0: the deceased
1: the injured who can be helped by immediate transportation
2: the injured whose transport can be delayed
3: those with minor injuries, who need less help
Advanced Triage: Advanced triage, on the other hand, determines whether or not seriously injured people should receive advanced care due to their unlikeliness to survive. This is where the ethical implications come in.
Since treatment is intentionally withheld from patients, people will always comfort the procedure with ethical “right-or-wrong” questions. But again, advanced triage is just as necessary to preserve scarce resources for those who can benefit from it more. Those implementing the triage process often undertriage or overtriage patients, leading to complications with incorrect patient labeling.
Triage is constantly changing and checked to ensure that the priority remains correct: to ensure that the hospital emergency room provides medical care to those who need it the most.