Triage

Edwards M. Triage. Lancet 2009 May 2;373(9674):1515.

The prosaic origins of triage belie its current militaristic overtones. Derived from the 14th-century French verb trier, to pick or sort, triage first appeared in English early in the 18th century to describe the grading of fleeces according to wool quality. In the 19th century the term also included the sorting of coffee beans. The first use of triage in the context of assigning levels of urgency to the treatment of military casualties occurred around 1930, and the term became widely used in British and American military parlance from the mid-1930s.

The 1930 use of triage, however, described a process that had been practised for over a century. Napoleon's surgeon in chief, Dominique-Jean Larrey, devised one of the first systems to allocate treatment to battlefield casualties according to the seriousness of their injuries rather than, as previously, their rank or nationality. The Russian surgeon Nikolai Pirogov developed a more formalised procedure during the Crimean War, in which injured combatants were graded according to a four-point classification of urgency.

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