**5. Medical triage in an OTD**

Medical sorting is performed in the OTD. According to the severity of the OTD, the distribution of the victims by sorting groups allows for homogeneous treatment and prevention measures [7–10, 16–18, 27]**.**

Depending on the severity of the injuries the victims are sorted into two main groups in Bulgaria [7, 10]**:**

	- Group T4. Dying and agonizing;
	- Group T3. Injured with some slightly graded cranio-cerebral injuries or some insignificant spinal cord injuries and others slightly injured (20–40%). These are persons with injuries of the small bones of the frontal part of the skull (mandible, nose), medium and small soft tissue injuries, etc.;
	- Group T 2. Persons to whom medical care can be postponed for 6–8 hours (20%). These victims have an advantage of transportation, but do not need extreme treatment. These include victims with some surface thoracic or

**Figure 3.** *Triage groups in an OTD. (the worst prognostic option).*

abdominal injuries, or some not penetrating injuries to the uro-genital tract, or some negligible blood vessels rupture, burns less than 20% of the body surface in people of active age, but without other injuries;

• Group T 1. Persons whose trauma is defined by immediate vital disorders (20–40%). This group includes victims with respiratory failure, cardiac arrest, ventricular fibrillation, huge bleeding, shock, increased intracranial pressure, burns of the face and respiratory tract, or extensive burns occupying more than 20% of the body surface; poly-trauma, etc. The victims of this group receive emergency first aid in order to stabilize the basic vital functions and have the highest priority in treatment.

Particular attention in medical sorting should be paid to groups dangerous to others and in need of urgent medical attention. Dangerous for others are those infected with poisonous substances, radioactive substances, bacterial agents and patients with particularly dangerous infections (PDI), acutely unlocked or exacerbated chronic psychiatric diseases, some acute mental disorders etc. This danger imposes the need for sanitary treatment of the infected and isolation of patients with PDI, mental disorders as well.
