Major Incident Triage: quick reference

Before an incident

1. Open the app once with signal. Wait for ✓ Ready offline in the blue bar.
2. iPhone: Safari → Share → Add to Home Screen. Android: tap Install (or Chrome menu → Install app). Always open it from the home-screen icon.
3. iPhone: set Auto-Lock to Never while on scene.
4. Practise in Training mode (⚙ → Training mode). Orange banner = practice only; real records are untouched.

Start

1. Type your name / call sign.
2. Tap your role (healthcare professional, or non-clinical).
3. Optional: under Options, type the incident code — the same on every phone.

Triage a patient

1. Tap START TRIAGE. Answer YES / NO.
2. Not sure? Follow the yellow hint — it gives the safer answer.
3. Read the category and attach the matching label.
4. Tapped the wrong button? ↩ Change last answer.
5. Next Patient → for the next casualty.

Paper tag or wristband? Start → Options → Patient ID mode → Scan tag: the camera reads its barcode or QR as the patient ID. No barcode? Tap Read the printed number in the scanner and confirm what it read. 📷 Receive patient with a tag the phone already has opens that patient.

Start again: home → More → 🧹 Clear everything and start again (a real-use phone with records asks you to type CLEAR).

Hand over one patient (two phones)

1. Sender: open the patient → 📱 QR Handover.
2. Receiver: 📷 Receive patient → scan → check → Accept.
3. Receiver's phone shows a confirmation code.
4. Sender: 📷 Scan their confirmation code. Done — both phones record it.

Send many patients

1. More → Send patients to another device → choose all / sector / on scene.
2. Show QR codes. Receiver: 📷 Receive patient and keep the camera on the codes (any order).
3. No luck scanning? Export transfer file and send it by AirDrop / Nearby Share; receiver uses Import transfer file.

Records for debrief and inquiry

• 📋 Patient log → Casualty Register (CSV), Audit Trail (CSV), Full Incident Archive (JSON).
• Verify audit trail shows a head hash — photograph it.
• Close / Reset incident needs a saved archive first.

TST — Ten Second Triage (anyone)

1. Walking? YES → P3
2. Severe bleeding? YES → pressure, tourniquet, packing → P1. Once it is controlled: not talking but breathing → recovery position (leave the tourniquet on)
3. Talking? YES → penetrating injury, front or back? YES → P1; NO → P2
4. Not talking: Breathing? (open airway if able) YES → recovery position → P1; NO → Not breathing (CPR if resources allow)

Any child under 2 → P1 (national TST guidance; not printed on the card), but check for severe bleeding first and treat it. TST labels have a checked border. Re-triage about every 15 minutes, and with MITT as soon as possible.

MITT — NHS Major Incident Triage Tool (clinicians)

1. Catastrophic bleeding? YES → pressure dressing, tourniquet, haemostatic packing → P1
2. Walking? YES → P3
3. Breathing? (open airway if required) NO → Dead*
4. Responds to voice? NO → recovery position → P1
5. Aged over 2 years? NO → P1
6. Breathing rate 12–23? NO → P1
7. Heart rate 100 or more? YES → P1; NO → P2

* Children (<12) not breathing: if resources allow, consider 5 rescue breaths if submersion, immersion or smoke inhalation. MITT labels are solid colour.