Triaging patients prior to the arrival of the mass casualty: Emergency Severity Index equivalency to SALT disaster triage




disaster medicine, disaster planning, disasters, Mass Casualty Incidents, triage


Objective: To compare the Emergency Severity Index (ESI) and Sort Assess Life Saving Interventions Treatment and Transport (SALT) triage categories for an existing emergency department (ED) patient population.

Design: A prospective, cross-sectional study.

Setting: An academic-affiliated community teaching ED at a Level 1 Trauma Center.

Participants: All patients presenting to the ED over 2 nonconsecutive 24-hour weekdays.

Main outcome measures: The correlation between triage system classifications was assessed using the Spearman’s rank correlation coefficient.

Results: 100 percent of ESI 5, 83.3 percent of ESI 4, and 70.4 percent of ESI 3 were categorized as Minimal under SALT. 70.8 percent of ESI 2 was categorized as Delayed, and 71.4 percent of ESI 1 designations correlated with Immediate. Spearman’s rank correlation coefficient was 0.509 (p < 0.001).

Conclusion: This study results suggest that ESI moderately correlates with SALT, particularly in lower acuity patients. This result may inform future protocol development for rapid triage of existing ED populations prior to the arrival of patients from a mass casualty event.

Author Biographies

Bryan J. Wexler, MD, MPH

Department of Emergency Medicine, Wellspan York Hospital, York, Pennsylvania

Barbara A. Stahlman, MS

Department of Emergency Medicine, Wellspan York Hospital, York, Pennsylvania


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How to Cite

Wexler, MD, MPH, B. J., and B. A. Stahlman, MS. “Triaging Patients Prior to the Arrival of the Mass Casualty: Emergency Severity Index Equivalency to SALT Disaster Triage”. American Journal of Disaster Medicine, vol. 17, no. 2, Apr. 2022, pp. 127-30, doi:10.5055/ajdm.2022.0426.




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