deteriorate to "Urgent". Routine: evacuate within 24 hours to complete treatment. In a "naval combat situation", the triage officer must weigh the tactical situation with supplies on hand and the realistic capacity of the medical personnel. This process can be ever-changing, dependent upon the situation and must attempt to do the maximum good for the maximum number of casualties. Field assessments are made by two methods: primary survey (used to detect & treat life-threatening injuries) and secondary survey (used to treat non-life-threatening injuries) with the following categories: Class I: Patients who require minor treatment and can return to duty in a short period of time. Class II: Patients whose injuries require immediate life sustaining measures. Class III: Patients for whom definitive treatment can be delayed without loss of life or limb. Class IV''': Patients requiring such extensive care beyond medical personnel capability and time. Limitations of current practices Notions of mass casualty triage as an efficient rationing process of determining priority based upon injury severity are not supported by research, evaluation and testing of current triage practices, which lack scientific and methodological bases. START and START-like (START) triage that use color-coded categories to prioritize provide poor assessments of injury severity and then leave it to providers to subjectively order and allocate resources within flawed categories. Some of these limitations include: lacking the clear goal of maximizing the number of lives saved, as well as the focus, design and objective methodology to accomplish that goal (a protocol of taking the worst Immediate – lowest chances for survival – first can be statistically invalid and dangerous) using trauma measures that are problematic (e.g., capillary refill) and grouping into broad color-coded categories that are not in accordance with injury severities, medical evidence and needs. Categories do not differentiate among injury severities and survival probabilities, and are invalid based on categorical definitions and evacuation priorities ordering (prioritization) and allocating resources subjectively within Immediate and Delayed categories, which are neither reproducible nor scalable, with little chance of being optimal not considering/addressing size of incident, resources, and injury severities and prioritization within its categories – e.g., protocol does not change whether 3, 30 or 3,000 casualties require its use, and regardless of available resources to be rationed not considering differences in injury severities and survival probabilities between types of trauma (blunt versus penetrating, etc.) and ages resulting in inconsistent tagging and prioritizing/ordering of casualties and substantial