Reverse triage vs reg triage, priority questions

[SaltySarcasticSally, LPN, RN]

I have no idea why I am not grasping this concept but suggestions/input please.

Prepping for NCLEX, I do just fine with in patient priority questions. I am struggling with priority questions like:

- A nurse arrives to the scene of accident, they have 4 patients, who do they see first?

- When a mass causality incident is sending patients to the hospital, who will you evaluate first when they arrive? Again, usually 4 patients.

I think I'm am getting confused when to do reverse triage vs regular triage. Also, I know out in the field when a patient is a "black tag" (obviously doesn't say in question) that your supposed to just skip over them because there is nothing you can do. But I have had questions when they make it to the hospital, the answer is you see them first. So now I never who to pick.

Please help

[bgxyrnf, MSN, RN]

I'm not familiar with the concept of "reverse triage."

I am intimately familiar with ESI triage in which an immediately life-threatening issue (think ABCDs) gets a 1; a high-risk situation or a patient in severe distress gets a 2; a 'basic' patient expected to utilize multiple resources (lab, Xray, RT, IV/IM meds, etc) gets a 3; a simple patient expected to use 1 resource gets a 4; and a patient expected to use no resources gets a 5... See the patients in ascending order 1-5.

For an MCI, tell everyone to move to a certain area... everyone who does gets a Green tag. Then do a quick ABCD.

Are they breathing? If not, open the airway. Now are they breathing? If not, Black tag. If they start breathing, Red tag.

Check the respiratory rate. Is it >30? If yes, Red tag.

Check perfusion via cap refill and radial pulse. No radial pulse or cap refill > 2 sec? Red tag.

Check mental status. Do they follow commands? If no, Red tag. If yes, Yellow tag.

See the reds then the yellow then the greens.

If you have actual questions, I'll try to help you reason them through.