First aid for multiple casualties isn’t just about helping whoever is closest or who looks like they need the most help. When multiple people are injured, rushing toward the most visible casualty may not lead to the best outcomes for everyone involved. Triage gives structure to chaos, which gives a single rescuer the best chance to direct their efforts where they will have the greatest impact.
What Is Triage?
Triage is the process of sorting casualties based on the severity of their injuries and their need for medical attention. The word comes from the French verb “trier,” meaning to sort or select. The core principle of triage is to do the greatest good for the greatest number of people. This does not mean choosing who deserves help and who does not. It means allocating limited resources in a way that gives the most people the best chance of survival.
Triage systems use colour-coded categories to sort casualties.
Red (Immediate): Casualties in this category have life-threatening injuries but a high potential for survival if treated first. Examples include severe bleeding that can be controlled with direct pressure, airway obstruction that can be cleared, and people who have stopped breathing but may respond to CPR and defibrillation. A person who is bleeding heavily or is unconscious but still breathing belongs in this category.
Yellow (Delayed): These casualties have serious injuries that can wait for treatment while you attend to Red category casualties, but their conditions will worsen without eventual care. Examples include fractures that are not causing catastrophic bleeding or moderate burns.
Green (Minor): These casualties have minor injuries and can often help themselves or assist others. They can walk, talk, and follow instructions. Green category casualties should move away from the area to a safe space where they can wait for medical help.
Black (Deceased or Expectant): This category includes those who have died or whose injuries are so severe that survival is unlikely even with immediate advanced care. Assessing someone as Black is one of the most difficult aspects of triage, but reflects the principle of doing the greatest good for the greatest number.
Providing First Aid For Multiple Casualties: Step-by-Step
A scene with multiple casualties requires a structured approach to help you provide first aid for multiple casualties without becoming overwhelmed.
Ensure scene safety
Your priority is to avoid becoming another casualty. Before approaching the scene, scan the environment for hazards.
Is there traffic approaching? Electrical wires down? Fire spreading? Smoke or chemical fumes? Structural damage that could cause further collapse? Safely remove the hazard or move the casualties away if you can.
Call triple zero (000)
Call triple zero as soon as you can. If there are other bystanders, have someone else do it for you so you can help people directly.
Conduct a rapid triage assessment
Start by calling out loudly: “If you can hear me and walk, please move over here.” Point to a safe area away from hazards. Anyone who walks to that area has self-triaged into the Green (Minor) category.
Move through the scene and assess each casualty into the other triage categories so you know where to direct your efforts. Check for responsiveness by speaking to them and gently squeezing their shoulders, assess whether they are breathing, and note any obvious life-threatening injuries. Do not spend more than 30 to 60 seconds on each person.
Group casualties physically by moving them (if safe to do so) to designated areas. Use verbal instructions: “Stay here, help is coming for you soon.” Use improvised markers if available, such as different coloured items. The walking wounded in the Green group may be able to help with this process.
Treat Red casualties
Return to those in the Red (Immediate) category these are the people whose lives you can save by knowing first aid. Work through them one at a time, spending only as long as needed to stabilise each person before moving to the next one. If a Red casualty requires ongoing attention, such as someone to maintain direct pressure on a wound, delegate that task to a bystander so you can continue to the next person.
Monitor for changes
Conditions change as time passes and a casualty you categorised as Yellow (Delayed) may deteriorate and need to be upgraded to Red (Immediate). Monitor the scene as you go and adjust your priorities as needed.
Handover
When emergency services arrive, give them a clear handover. Report how many casualties there are, how you have categorised them, what treatment you have provided, and any changes you have observed. Step back and follow their instructions, as they will take command of the scene and may reassign your tasks.
A First Aid Course Can Prepare You For Any Emergency
First aid for multiple casualties requires the ability to make rapid assessments and prioritise action under pressure. The life-saving skills that help first responders save lives in a multiple casualty incident aren’t learnt on the field, they’re learnt through an accredited first aid training course. HLTAID014 Provide Advanced First Aid builds on the first aid treatment skills to cover emergency situations like first aid for multiple casualties.
FAQs
What Items Should Be in a First Aid Kit?
A basic first aid kit should have dressings, bandages, adhesive tape, gauze, disposable gloves, scissors, and saline solution as basic items.
Can I Be Sued For Providing First Aid Incorrectly?
Australian law protects those who provide reasonable assistance in emergencies under Good Samaritan legislation. Those who provide first aid for multiple casualties acting in good faith and are not intoxicated at the time are legally protected.
What If I Cannot Tell How Serious an Injury Is?
When in doubt, assign the more urgent category. A casualty you place in Yellow who deteriorates can be upgraded to Red when you reassess the scene.
