SALT mass-casualty triage guideline

The SALT mass-casualty triage guideline appears in the book as a proposed national standard for mass-casualty triage, emerging from research that compared existing systems and sought to improve coordination among organizations in emergencies. The account identifies its place in that effort but does not describe its operational steps or say that it was used at Memorial Medical Center during Hurricane Katrina.

Definition and Development

The guideline is named among the systems examined by researchers evaluating mass-casualty triage. Their 2008 article compared nine recognized approaches: START, Jump START, Homebush, Triage Sieve, Pediatric Triage Tape, CareFlite, the Sacco Triage Method, Military Triage, and CESIRA. From that comparison, the authors proposed SALT as a new national standard. The book does not expand the name or specify how the guideline assigns categories or directs treatment.

Coordination Across Systems

The research effort did not stop at proposing a common standard. A later 2011 article refined the evaluation of mass-casualty triage, and the researchers subsequently developed techniques intended to help organizations using different systems work together during emergencies. SALT therefore belongs to a larger standardization and coordination project: the problem described is not only how to sort patients, but also how different responders can act compatibly when their existing methods vary.

Distinction from Memorial’s Evacuation Decisions

The book separately describes Memorial Medical Center’s decision to evacuate patients with Do-not-resuscitate (DNR) orders last. Doctors established that priority during the hospital’s evacuation, and one physician later explained that he believed DNR patients had the least to lose if disaster struck. This was a specific local evacuation decision, not an application of SALT identified in the account. A DNR order concerned whether a patient should be resuscitated if breathing or heartbeat stopped; placing those patients last for rescue was a separate interpretation with consequences for evacuation.

Disaster Context and Evidentiary Limits

The surrounding account shows why triage and emergency planning mattered, without attributing particular actions to SALT. Before Hurricane Katrina, Memorial’s leaders had studied storm-surge models, and an engineer warned that relatively little street flooding could disable critical parts of the hospital’s power-distribution system. During the crisis, the generators failed and evacuation decisions unfolded amid severe operational constraints. The book also describes Charity Hospital’s preparations and the use of portable generators to sustain critical equipment. These accounts provide context for the pressures under which disaster-care systems operate; they do not establish that either hospital used the SALT guideline. The available description supports identifying SALT’s research origins and coordination purpose, but not reconstructing its procedures or judging its performance in the events narrated.