Prolonged Field Care Podcast Prolonged Field Care Podcast: Mastering Triage
Oct 9, 2025
Andrew Shifrina, an emergency medicine physician with deployment experience, joins to discuss the intricacies of triage in mass casualty situations. He emphasizes intuitive methods over rigid algorithms, insisting on recognizing immediate life threats first. The conversation highlights the critical role of leadership and continuous reassessment in chaotic scenarios. Andrew also advises integrating security measures into training, recommending realistic drills that prepare teams for tough decisions, including prioritizing who goes to surgery. Effective communication amid crisis is underscored as essential.
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Algorithms Fail In High-Volume POI
- Traditional triage algorithms take 30–60 seconds per patient and often fail in large point-of-injury events.
- In practice responders use a binary, life-threat focused sweep rather than rigid linear algorithms.
Helicopter Crash Rapid Triage
- Andrew described a helicopter crash where he was the only able medic initially and had to triage 21 people quickly with 10–15 second checks.
- He used a rapid 'who's dying now' sweep focusing on breathing, pulse, and massive hemorrhage to prioritize care.
Follow Move, Treat, Transport
- Prioritize move, treat, transport: move people out of danger, treat immediate life threats, and get them to the next level of care.
- Use a quick life-threat sweep first, then apply more detailed triage once patients are stabilized.