Culley, J., Svendsen, E., Craig, J., and Tavakoli, A. (2014). A Validation Study of 5 Triage Systems Using Data from the 2005 Graniteville, South Carolina, Chlorine Spill. Journal of Emergency Nursing. 40(5):453-60.
The authors used data from the 2005 Graniteville, SC chlorine spill to evaluate the appropriateness of 5 commonly used triage systems for assessing casualties from chemical events. They found that the five triage systems did not agree with the actual injury severity from a chemical exposure and that “oxygen saturation measured by pulse oximetry provides early indications and is very predictive of outcome severity in incidents involving irritant chemical exposures such as chlorine.” The article emphasizes the notion that trauma-derived mass casualty triage criteria may not apply well to chemical incidents.