In Norway, a train accident near Aasta killed 19 people whereas 67 passengers survived. Approximately 600 personnel from different 11 services participated in the initial management of this major incident [25]. A review of the World Trade Center attack in 2001 concluded that “the lack of communication resulted in more problems than all other factors combined” [26]. Further, during a major aircraft incident in UK, the simultaneous use of

several different triage-labelling systems contributed to confusion [27]. A triage concept with uniform instructions and standardized triage tagging would alleviate on-scene confusion and national standards has been called Inhibitors,research,lifescience,medical for both in the US and Australia [14,28]. In Norway, the lack of a standard major incident triage concept that is nationally accepted, reliable and validated remains a gap in our major incident preparedness. Conclusions Major incident triage skills can be effectively taught to multi-disciplinary emergency service professionals using a combination of lectures and practical simulations in a two-day course. Our Inhibitors,research,lifescience,medical modified triage Sieve tool provides acceptable accuracy in allocating priority during simulated

major incidents and may serve as a candidate for a future national standard for major incident triage. Competing interests Declared. The TAS-courses are funded and organized by the Norwegian Inhibitors,research,lifescience,medical Air Ambulance Foundation. Trond Vigerust is a hired consultant for Inhibitors,research,lifescience,medical LESS, a manufacturer of emergency stretchers. All other authors declare no conflict of interest. Authors’ contributions MR, HML, AJK, TV and JEA conceived the study. MR, AJK, TV and JEA designed the study. JEA supervised the data collection. TV, AJK and MR managed the collected data. MR performed the analysis and drafted the manuscript. All authors interpreted data and this website critically revised the manuscript. All authors have read and approved the final manuscript. Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/10/17/prepub Inhibitors,research,lifescience,medical Supplementary Material Additional file 1: Example of patient information card. Status

inside bus wreck and at casualty clearing station. Click here for file(427K, PPT) Additional file 2: Questionnaire. Word file containing questionnaire (in Norwegian language). Click here for file(307K, DOC) Acknowledgements We acknowledge Thymidine kinase and thank Torfinn Hallerud, Bent Krister Osbakk, Kai Tangen, Børre Østby and Janne Lisbeth Støylen Bådholm for their willingness to participate and support this project, and for their continued dedication to improved inter-disciplinary management of major incidents. We thank Prehospital Katastrofmedicinsk Centrum, Gothenburg, Sweden for friendly advice and thoughtful input. We thank Lars Erik Vollebæk for assistance with graphical design. We are grateful to all emergency service professionals participating in a TAS-course.