• James Vassallo, Jason E Smith, Stevan R Bruijns, and Lee A Wallis.
• Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa; Institute of Naval Medicine, Alverstoke, Gosport, UK. Electronic address: vassallo@doctors.org.uk.
• Injury. 2016 Sep 1; 47 (9): 1898-902.

IntroductionTriage is a key principle in the effective management of major incidents. The process currently relies on algorithms assigning patients to specific triage categories; there is, however, little guidance as to what these categories represent. Previously, these algorithms were validated against injury severity scores, but it is accepted now that the need for life-saving intervention is a more important outcome. However, the definition of a life-saving intervention is unclear. The aim of this study was to define what constitutes a life-saving intervention, in order to facilitate the definition of an adult priority one patient during the definitive care phase of a major incident.MethodsWe conducted a modified Delphi study, using a panel of subject matter experts drawn from the United Kingdom and Republic of South Africa with a background in Emergency Care or Major Incident Management. The study was conducted using an online survey tool, over three rounds between July and December 2013. A four point Likert scale was used to seek consensus for 50 possible interventions, with a consensus level set at 70%.Results24 participants completed all three rounds of the Delphi, with 32 life-saving interventions reaching consensus.ConclusionsThis study provides a consensus definition of what constitutes a life-saving intervention in the context of an adult, priority one patient during the definitive care phase of a major incident. The definition will contribute to further research into major incident triage, specifically in terms of validation of an adult major incident triage tool.Copyright © 2016 Elsevier Ltd. All rights reserved.

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