Triage: in austere environments and echeloned medical systems.

Although triage as a medical sorting process was originally developed and applied to echeloned military field medical systems dealing with mass casualties, the term has now permeated most aspects of medical practice. This essay attempts to refocus on triage in military and disaster settings, emphasizing the relationship of the echeloned system organization to the triage process, and the various non-medical factors which may influence triage decisions and priorities. Due to the lack of any analogous civilian experience, it is essential that all health personnel who may be involved in an echeloned care system gain and maintain proficiency by frequent involvement in appropriate training exercises, the characteristics of which are described.