Table 2 Statements and responses in the first round of the Delphi study. Response 100% (19/19)

1. All ambulatory cases, irrespective of symptoms, will be PRIMARY triaged as Green (delayed/P3)

81

19

Ambulatory circumferential burn/ severe oral injury?

Observe burn inhalation

2. Absence of breathing is enough to distinguish between salvageable or dead (PX) victims

75

25

Only after clearing the airway

Should declare the patient as "no sign of life" since death is a legal definition?

3. In question no. 2, the lack of breathing is enough to initiate intervention, such as positioning of the airway (Jaw trust/chin lift/head tilt). Please note no medical devices (e.g., Guedel) are available

89

11

The lack of staff can make maneuvers such as "chin lift" or "jaw thrust" useless. The lateral safety position might be useful despite the potential risk of spinal injury

If no breathing, just move on. Spending more time with victims to open airways may delay treatment of others

4. One intervention attempt is enough to validate between salvageable/dead (PX)

80

20

It allows managing multiple patients

The opening airway is enough to determine to breathe

5. Observation of major external hemorrhage is enough to triage the victim Red/P1 patient

95

5

This is in line with the C-ABC philosophy

A simple sign to detect and indicates a life-threatening situation

Immediate action to control

6. In question no. 5, the external hemorrhage is enough to initiate intervention

100

0

Needs to be fast and efficiently such as tourniquet and/direct pressure

That is according to the C-ABC concept

Interventions always depend on the presence of sufficient staff

Staff must cut clothing and identify the site of bleeding/ P1

7. When initiating intervention according to question number 6, applying direct pressure to active bleeding in the thorax/abdomen is a sufficient intervention

70

30

A tourniquet should be used as the last resort

Direct pressure is the most feasible intervention in proximal non-compressible injury in a major incident setting

8. When initiating intervention according to question number 6, applying a tourniquet to extremities, above active bleeding, if the direct pressure fails or you have to release it, is a sufficient intervention

94

6

This approach is effective in stopping bleeding and takes less time

A tourniquet is more sufficient than direct pressure alone

Direct pressure OR tourniquet—pick one and move one

9. With no external hemorrhages, it is sufficient to evaluate the victim’s circulatory status by palpating radial or peripheral pulse

85

15

And Capillary Refill

Carotid

10. The lack of radial or peripheral pulse is enough to triage the victims as Red/P1

81

19

Capillary refill more than 2 S

Check quickly for any other indicators, Carotid or capillary refill

11. Victims, who breathe, have radial or peripheral pulse but show signs of respiratory distress, i.e., having trouble breathing or not getting enough oxygen (a bluish color seen around the mouth, on the inside of the lips, or the fingernails may happen) will be triaged as Red/P1

95

5

These signs indicate critical status

Signs or symptoms of abnormal breathing should be checked and treated asap

Airway, breathing, circulation. Any breathing problems should be dealt with as a priority until a secondary survey is done

12. Victims, who breathe, have radial or peripheral pulse, and have no respiratory distress, who are unable to follow commands, are triaged as Red/P1

88

12

A reduced level of consciousness may be an indicator of severe head injury and/or hypovolemia

Severe traumatic brain injury might be present

13. Victims, who breathe, have radial or peripheral pulse, and no respiratory distress, who are able to follow commands, are triaged as Yellow/P2

95

5

This warrants that they have some kind of injury

Immediate intervention or procedure is not indicated at that time

Stable enough to wait a bit until P1's are treated