Ten Second Triage (TST) is a new rapid assessment system developed and published by the NHS in 2023, used by many emergency response services and hospitals in the UK to evaluate and categorise patients for priority treatment. It was designed to improve the efficiency and effectiveness of triage during mass casualty incidents, with the objective being to determine the priority of care for each casualty within 10 seconds or less. Using TST allows first responders to quickly assess which casualties need immediate medical attention and who can wait for further evaluation, treatment, or transport to the appropriate facility.

Simple and effective triage

One of the key features of Ten Second Triage is its simplicity, which allows it to be used by any first responder present at a major incident. TST is designed to be used by a wide range of personnel with minimal technical training to facilitate swift decision-making in multiple casualty incidents. Unlike some other triage systems, TST is accessible to responders without a medical background, including police officers, firefighters, and other non-medical personnel, in addition to specialist medical staff.

How does TST work?

Ten Second Triage follows a simple algorithm based on the patient’s condition. Unlike traditional triage systems, TST does not rely on clinical measurements such as pulse and heart rate, but focuses on a visual assessment of whether the patient is walking, talking, and breathing, and looks for the presence of any central penetrating injury. Each question has a quickfire ‘yes or no’ answer, with a yes prompting the responder to move onto the next question, and a no answer determining priority of treatment. 

These are:

• P1 (Priority One): patients requiring immediate life-saving interventions

• P2 (Priority Two): patients needing urgent medical attention but who do not have an immediate life-threatening condition, so can tolerate a short delay in treatment

• P3 (Priority Three): patients with minor injuries or non-life-threatening conditions who can wait longer for medical care without incurring risk.

• Dead: individuals who show no signs of life and for whom resuscitation efforts are deemed futile.

This prioritisation system makes TST fast and effective at prioritising large numbers of casualties in a short period of time, while also simplifying the process and making it more accessible for non-medically trained responders.

Overview of Ten Second Triage

Ten Second Triage (TST) is a patient assessment method used in hospitals and emergency response settings. Key aspects of TST include:

Process Features

• TST provides a framework for initial patient assessment and categorisation during mass casualty events or high-volume scenarios.

• The method uses four categories to classify patients based on observed condition and apparent medical needs.

Implementation Characteristics

• The assessment process is designed to be completed quickly, aiming to enable decisions about patient prioritisation.

• It relies on observable indicators rather than detailed physiological measurements.

Clinical Applications

• TST can be used to guide immediate interventions for time-sensitive conditions, including penetrating injuries and airway obstruction.

• The categorisation system helps inform decisions about resource allocation during multiple casualty incidents.

Find out more

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