Status of Clients with Yellow Tags in a Mass Casualty Incident
Clients with yellow tags in a mass casualty incident are classified as "urgent" patients who have severe injuries but whose transport can be delayed as they are not in immediate danger of death.1
Triage Classification System
In mass casualty incidents (MCIs), patients are typically categorized using a color-coded triage system:
- Red (Immediate): Critically injured patients who require immediate transport and intervention to save their lives 2
- Yellow (Urgent): Severely injured patients whose transport and treatment can be delayed without immediate risk to life 2, 1
- Green (Delayed): Patients with minor injuries who need help less urgently 1
- Black/Blue: Deceased or expectant patients who are unlikely to survive given the available resources 2
Characteristics of Yellow Tag Patients
Yellow-tagged patients typically present with:
- Severe injuries that require medical attention but are not immediately life-threatening 2, 1
- Stable vital signs that do not indicate imminent deterioration 2
- Injuries that can tolerate a delay in definitive care without significant increase in morbidity or mortality 2
Priority for Treatment
In the allocation of limited resources during an MCI:
- Red-tagged patients receive priority for ICU admission and immediate interventions 2
- Yellow-tagged patients receive the next level of priority after red-tagged patients 2
- These patients should remain in critical care if already admitted and be reassessed at regular intervals (typically at 48 and 120 hours) 2
Clinical Management Considerations
- Yellow-tagged patients require ongoing monitoring as their condition may deteriorate, potentially requiring reclassification to red status 2
- They should receive appropriate medical care within the constraints of available resources 2
- If resources become more limited, yellow-tagged patients may be reassessed using tools such as the Sequential Organ Failure Assessment (SOFA) score to determine ongoing priority 2
Common Pitfalls in Yellow Tag Management
- Undertriage: Failing to identify patients who should be classified as red can result in delayed treatment and increased mortality 1
- Overtriage: Incorrectly classifying patients as red when they should be yellow can deplete resources needed for truly critical patients 1
- Inadequate reassessment: Yellow-tagged patients require regular reassessment as their condition may change 2
- Resource allocation challenges: During prolonged MCIs, determining how to allocate resources between red and yellow patients becomes increasingly difficult 2
Practical Application
- Yellow-tagged patients should be placed in a designated treatment area where they can be monitored while awaiting definitive care 3
- Documentation of their injuries, treatments provided, and reassessment findings is essential for continuity of care 2
- As resources permit, yellow-tagged patients should be transported to appropriate facilities for definitive care 2
Yellow-tagged patients represent a significant challenge in mass casualty management as they require substantial medical resources but can tolerate some delay in receiving definitive care, allowing the most critical patients to be treated first 2, 1.