Triage and ABCDE: the essentials
Participant handout · WHO Basic Emergency Care · gpreasoning.uk/global
Reasoning GP
Global Primary Care
Triage
| Colour | Meaning |
|---|
| Red | Seen immediately |
| Yellow | Seen soon |
| Green | Can wait |
ABCDE: treat as you find
- A Talking? Noisy? Head-tilt and chin-lift; jaw thrust if trauma.
- B Rate, effort, wheeze, SpO2. Oxygen; bag-valve-mask if inadequate; salbutamol.
- C Cool hands, capillary refill over 3 s, pulse, BP, bleeding. Pressure; IV fluid.
- D AVPU, glucose, pupils, seizures. Recovery position.
- E Whole body; cover to keep warm; immobilise a bitten limb.
SAMPLE
Signs and symptoms · Allergies · Medications · Past history (and pregnancy) · Last oral intake · Events
Key doses (adults; follow national protocol)
- Anaphylaxis: adrenaline 1 mg/mL, 0.5 mg IM; child 0.15 mg; repeat as needed.
- Shock: 1 litre saline or Ringer's lactate under 30 minutes; child 10 to 20 mL/kg; malnutrition or anaemia 10 to 15 mL/kg over 1 hour.
- Low glucose (below 3.5): 25 to 50 mL of 50% dextrose IV; child 5 mL/kg of 10%.
- Seizure: diazepam 10 mg slow IV; second dose after 10 minutes.
- Seizure in pregnancy: magnesium sulfate 4 g IV over 5 minutes plus 10 g IM.
Observer checklist
- Introduced self; checked danger
- ABCDE in order, treated as found
- Glucose checked if D abnormal
- Reassessed after each treatment
- SAMPLE history; SBAR handover
Transfer and SBAR
- Call ahead; written record goes with the patient.
- Airway kit, oxygen, secure IV, extra medicines.
- Reassess ABCDE every 15 minutes.
- Situation · Background · Assessment · Recommendation.
Sources
World Health Organization and International Committee of the Red Cross. Basic emergency care: approach to the acutely ill and injured (participant workbook and quick cards). 2018. World Health Organization. Basic emergency care course: transfer and handover slide set (SBAR). 2018. World Health Organization, International Committee of the Red Cross and Médecins Sans Frontières. Interagency Integrated Triage Tool (web page and tools). 2020.Adapted from WHO guidance; not endorsed by WHO. This page paraphrases and adapts the WHO publications listed under Sources, which are licensed CC BY-NC-SA 3.0 IGO; the adapted text is shared under the same licence for non-commercial education. Reasoning GP is not affiliated with WHO or any other organisation named here. Use it alongside your national guidelines, essential medicines list and formulary, and your clinical judgement. Doses are given only where they come from a WHO source; otherwise follow your national guideline or formulary.