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Book

EMS Reverse Triage

Joshua Justice  1 , Melissa D. Kohn, J R. Walker, III  2
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
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Book

EMS Reverse Triage

Joshua Justice et al.

Excerpt

Healthcare systems are inherently supply-constrained, with demand levels that fluctuate unpredictably. When demand exceeds the available supply of resources, healthcare systems must allocate these resources accordingly. During extreme demand, such as mass casualty incidents or natural disasters, the system can become nearly nonfunctional due to overwhelming need.

Hospitals are expected to maintain functionality for up to 96 hours without external resources. However, to remain functional in the face of such extreme demand, these facilities must either increase available resources or redistribute them more efficiently.

Strategies aimed at helping hospitals and healthcare systems handle surges in unanticipated demand have garnered increasing academic interest. Inspired by the military tactic of prioritizing the least injured soldiers to conserve resources for the more critically injured, reverse triage has been recommended in the literature as a method to address situations of unusually high demand.

Reverse triage focuses hospital resources on critically ill patients in the field or emergency department by identifying and discharging admitted patients who have a relatively low risk of complications if discharged early. This strategy aims to reduce morbidity and mortality for the greatest number of patients while maximizing treatment capacity in the shortest time.

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Conflict of interest statement

Disclosure: Joshua Justice declares no relevant financial relationships with ineligible companies.

Disclosure: Melissa Kohn declares no relevant financial relationships with ineligible companies.

Disclosure: J Walker, III declares no relevant financial relationships with ineligible companies.

References

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    1. Kelen GD, Troncoso R, Trebach J, Levin S, Cole G, Delaney CM, Jenkins JL, Fackler J, Sauer L. Effect of Reverse Triage on Creation of Surge Capacity in a Pediatric Hospital. JAMA Pediatr. 2017 Apr 03;171(4):e164829. - PubMed
    1. Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003 Feb 04;138(3):161-7. - PubMed

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