Triage systems around the world: a historical evolution

Abstract

The process of triaging patients has come a long way. Stemming from the battlefield, it is the ability to sort casualties on the severity of their injuries that has improved the allocation of resources. In modern emergency centres, there is a constant struggle to balance limited resources against the ever-growing patient need. Since the late 1980s, when triage became the mainstream standard for sorting patients, many different systems have developed throughout the world. There was a rise in triage system design as emergency centres became more streamlined and resource-conscious. Countries around the world sought to develop triage systems that would be most effective in their given setting—giving rise to multiple variations of the triage process. This narrative review will explore the evolution of triage systems around the world by presenting: a historical perspective, how and where modern systems developed, what the main characteristics are of different systems, and a discussion of the current state of triage system evolution.