Aims and Objectives Triage is a key principle in the effective management of major incidents. The speed that it is possible to perform triage is important, along with the speed at which key life-saving interventions (LSIs) be performed, e.g., management of external haemorrhage and airway opening manoeuvres. In 2023, an NHS England working group developed the Ten Second Triage (TST) tool. We describe the field-testing process that was undertaken prior to its introduction.

Method and Design A simulated major incident exercise with 37 casualties (33 live ‘patients’, 4 mannequins) was conducted at the NARU Education Centre, Salisbury. Both specialist and non-specialist responders from Police, Ambulance and Fire Services took part. A total of eight ‘runs’ were conducted (table 1), each ‘run’ consisting of ten responders from each emergency service plus a team leader. Quantitative assessments of overall accuracy of triage and time taken from entry on scene through to completion of necessary LSIs for all casualties were conducted. Qualitative assessment was conducted independently by the Health Security Agency.

Results and Conclusion Ambulance personnel utilising the new NHS Major Incident Triage Tool (MITT) completed the scenario in 20minutes. ‘Runs’ two to six with TST took a mean time of 6mins 24secs. For ‘runs’ seven and eight, were the TST was performed prior to the MITT, the time taken to complete the MITT reduced to 10minutes (table 1).

The TST had an overall accuracy of 78% across all runs, with a corresponding over and under-triage rate of 18% and 4% respectively.

Conclusion: The TST is a rapid and accurate method of triaging patients requiring LSI, and delivery by all emergency services personnel is feasible. This study supports its adoption by NHS England.