In the Field
T1 through T4 is how MASCAL triage actually works. Each casualty gets assessed quickly, gets a category, gets a marker (tape, card, ribbon), and moves to the corresponding treatment area. The math is brutal but consistent: the surgeon and the limited blood product get used on T1s, who will live if treated and die if not. T3s get minor wound care and stay out of the way. T4s get palliated and reassessed only if resources free up. The category is not permanent - reassessment shifts patients between categories as treatment progresses or new resources arrive.
Common Mistake
Treating triage categories as permanent. A T1 who is rapidly resuscitated may become a T2 stable for delayed transport. A T2 who deteriorates becomes a T1. A T4 who is unexpectedly alive 30 minutes later with improving signs may be reclassified to T1 if resources now allow intervention. The other mistake is over-classifying as T1 because everyone looks bad. Real T1s are salvageable with immediate intervention; casualties with similar appearance but unsurvivable injuries are T4. Discipline in T4 designation is what makes T1 care possible.
Technical Detail
Military triage categories per NATO STANAG 2879 and US joint doctrine: T1 (Immediate, red) - requires rapid life-saving intervention; survival likely with treatment; airway compromise, severe hemorrhage controllable, tension pneumothorax, shock responsive to resuscitation. T2 (Delayed, yellow) - requires care but stable enough to tolerate delay; significant injury without immediate threat to life; long bone fractures with intact pulses, stable abdominal trauma. T3 (Minimal, green) - ambulatory, minor injuries; can be redirected to self-care or basic care; minor lacerations, sprains, walking wounded. T4 (Expectant, gray or blue) - unsurvivable injuries given available resources; palliate only; severe TBI without imaging or surgical capability, massive burns without burn center access, polytrauma exceeding resuscitation capacity. The civilian START (Simple Triage and Rapid Treatment) and SALT (Sort, Assess, Lifesaving Interventions, Treatment/Transport) systems use four categories that map approximately to military T1 to T4.
