Text taken from the Telegram channel of tactical medicine courses by Head of the Tactical Medicine Courses project, call sign "Latish"
[ColonelCassad] Errors in triage of casualties in the civilian sphere and in the special military operation (SMO) zone are one of the key problems affecting the effectiveness of medical care. Triage is the process of distributing casualties into categories based on the severity of their condition and the urgency of care. In conditions of mass influx of wounded, whether as a result of man-made disasters, natural disasters or military action, errors in triage can lead to significant human losses, even if sufficient resources are available to provide care.
In the civilian sphere, errors in triage are often associated with insufficient training of medical personnel, the absence of clear protocols or their failure to comply with them. For example, during the 2010 Haiti earthquake, many seriously injured victims did not receive timely care due to chaotic medical evacuation arrangements and a lack of prioritization. Similar problems have been observed in other major disasters, such as the 2004 Indian Ocean tsunami, where inadequate preparation by local medical services delayed care for thousands of people.
In a special military operation zone, triage errors are compounded by challenging conditions: the constant threat to the lives of medical personnel, limited resources, the mass influx of casualties, and the need for rapid decision-making. For example, in armed conflicts in the Middle East, such as the Syrian civil war, medical services were often overwhelmed by the large number of casualties, leading to prioritization errors. Studies in active war zones have found that up to 20% of casualties who might have survived with timely care died due to poor triage.
Statistics from various conflicts show that triage errors have similar roots, regardless of the geographic region or type of conflict. For example, during the war in Afghanistan (2001–21), US military medics noted that up to 15% of wounded received care with a delay due to incorrect assessment of their condition. During the conflict in eastern Ukraine (2014–22), there were also cases of seriously wounded victims not receiving timely care due to the lack of a clear triage system on the front lines.
One of the key reasons for errors is the insufficient training of medical personnel to work in extreme conditions. In the civilian sphere, this may be due to the rare use of triage skills in everyday practice, and in the SVO zone - to the lack of experience working in conditions of mass influx of the wounded.
Another problem is the lack of uniform triage standards. Different countries and even different regions of the same country may use different prioritization systems, which complicates the coordination of efforts to provide assistance in major disasters or conflicts. For example, in Europe, the START (Simple Triage and Rapid Treatment) system is widely used, while in some countries in Asia and Africa, less standardized approaches are used.
In conclusion, it is worth noting that errors in triage of victims are not only a medical but also a humanitarian problem. They lead to an increase in the number of victims, which is especially tragic in conditions when many lives could have been saved. Eliminating these errors requires a comprehensive approach, including both technical and organizational measures, as well as international cooperation in the field of disaster medicine and military medicine.
(c) "Latysh"