A review of mass casualty incident triage tools for hospital-based triage

Mass casualty incidents (MCIs) pose significant challenges to the healthcare systems, particularly in low-and lower-middle-income countries where prehospital triage is often limited, and hospitals face sudden surges of casualties. While triage tools have been widely studied for field use, their effectiveness in hospital-based MCI response remains unclear. This review examines peer-reviewed studies on hospital-based triage tools used during mass casualties, focusing on their accuracy and applicability. A comprehensive search of MEDLINE identified six relevant studies, conducted across various income settings and utilizing different methodologies, including simulation-based research, retrospective analyses, and real-world debriefings. Several tools were assessed, including Simple Triage and Rapid Treatment, the Modified CareFlight system, and homegrown triage models developed in Berlin and Iran. While some tools showed potential in prioritizing critically ill patients and managing resource allocation, their application in the real-world hospital settings remains insufficiently studied. Existing research is limited by small sample sizes, reliance on simulations, and a lack of validation in live MCI scenarios. Given these gaps, further research is essential to evaluate triage models in real-time, high-volume, and resource-limited environments to ensure effective hospital-based mass-casualty response.