Triage Protocol¶

Ranking-and-shedding protocol — instantiates Intermittent Burst Absorption

A rule set that rapidly sorts burst arrivals by urgency, severity, and reversibility so scarce capacity goes where it preserves the most important outcomes — and openly defers or drops the rest.

A Triage Protocol is the rule set that decides what scarce capacity works on first when a burst means not everything can be served at once. It rapidly classifies each arrival by explicit criteria — urgency, severity, reversibility, fairness, dependency — into bands that determine order of service, and it makes the hard part explicit: which items are deferred or dropped so the capacity goes where it does the most good. What makes it this mechanism is that it is the ranking logic itself, defined in advance and applied fast: not the queue that holds items (that enforces the order triage assigns) and not a rate cap (which sheds blindly by timing) — triage is the deliberate, criteria-based decision about relative worth under scarcity.

Example¶

A multi-vehicle crash produces more casualties at once than the arriving paramedics can treat simultaneously — a genuine, sudden spike in demand for scarce medical attention. Acting on instinct or arrival order would waste effort on the unsalvageable or the walking-wounded while someone treatable dies. Instead, responders apply a START triage protocol (Simple Triage and Rapid Treatment): each casualty is assessed in under a minute against fixed criteria — ability to walk, breathing, circulation, responsiveness — and tagged into categories (immediate, delayed, minor, deceased/expectant). Care then flows first to the "immediate" patients who will die without prompt intervention but can be saved, deferring the "minor" who can wait and, wrenchingly, the "expectant" who cannot be saved with the resources present. The protocol doesn't add paramedics or hold patients in a line; it decides the order, by explicit rule, so the scarce capacity present preserves the most survivable lives — and it makes the deferral and shedding decisions openly, by criteria, rather than by panic or proximity.

How it works¶

The distinguishing content is a fast, criteria-based sort that includes an explicit shed decision:

Classify against fixed criteria — a small, fast-to-apply set (urgency, severity, reversibility) that a responder can run in seconds under pressure, yielding a small number of bands.
Rank for service — the bands set order: the highest-value-under-scarcity work goes first, not the loudest or the earliest.
Make the shed explicit — the protocol names what is deferred or dropped and why, so the sacrifice is a governed decision rather than an accident of overload.
Re-triage as conditions change — reassess, because urgency shifts and a deferred item can become critical; a one-time sort goes stale in a moving burst.

Tuning parameters¶

Criteria set — which factors decide rank (pure urgency, or urgency weighted by reversibility, fairness, dependency). Richer criteria capture more nuance but slow the sort and invite dispute.
Number of bands — few and coarse (fast, consistent) versus many and fine (precise, slower and less reliable under pressure).
Speed vs. accuracy — how much assessment each item gets. Faster clears more arrivals but misclassifies more; more careful is accurate but a bottleneck of its own during a burst.
Shed line — where "defer" becomes "drop." A stricter line protects capacity for the top band but sacrifices more; a looser one tries to serve more at the risk of serving the critical too slowly.
Re-triage cadence — how often items are reassessed, trading the cost of re-checking against the risk of acting on a stale classification.

When it helps, and when it misleads¶

Its strength is that it makes scarcity's ordering deliberate and defensible: under a burst that can't serve everyone, capacity goes where it preserves the most important outcomes, and the painful defer/drop decisions are made by explicit criteria in advance rather than by arrival order, volume, or whoever pushes hardest.

The failure modes are real and ethically charged. Over-triage floods the top band (classifying too much as critical) until the priority means nothing and everyone waits; under-triage misses genuinely critical items and lets them deteriorate in a lower band.^[1] Because triage encodes whose needs come first, a biased or opaque criteria set can systematically disadvantage the least powerful — the ad hoc version tends to harm them first, which is exactly why the criteria should be explicit and reviewed. The classic misuse is invoking "triage" to rationalize a rationing decision already made on other grounds, dressing a resource cut in the language of clinical urgency. The discipline is to keep the criteria explicit, calibrated, and re-examined; to re-triage as conditions move; and to reserve the protocol for genuine scarcity rather than as cover for under-provisioning.

How it implements the components¶

priority_policy — the protocol is the ranking rule: the criteria and bands that determine which arrivals are served first, deferred, or routed when capacity can't take all.
degradation_or_shedding_gate — its explicit shed line specifies what is intentionally deferred or dropped when the burst exceeds the safe absorption envelope, by criteria rather than by accident.

It authors the ranking but does not itself hold the items or enforce their order over time — a Surge Queue does that — and it sheds by *worth, not by rate (Rate Limit with Burst Allowance).*

Instantiates: Intermittent Burst Absorption — it supplies the prioritization and explicit shedding that let scarce capacity preserve the most important outcomes under a spike.
Sibling mechanisms: Surge Queue · Rate Limit with Burst Allowance · Burst Buffer · Overflow Channel · Elastic Capacity Scaling · Peak Response Reserve · Backup Staffing Pool · On-Call Response Rotation · Incident Surge Team · Flash Crowd Playbook · Post-Burst After-Action Review

Notes¶

Triage decides the order; it does not create the place items wait or the capacity that serves them. It usually operates on top of a Surge Queue (which enforces the ranking and ages items) and alongside capacity mechanisms — a triage protocol with nowhere to hold the deferred items, and no capacity behind the top band, is a sort with no follow-through.

References¶

[1] In emergency medicine, over-triage (over-classifying non-critical cases as critical) and under-triage (missing critical cases) are the two calibrated-against error modes of any triage system; both degrade outcomes, and triage protocols are explicitly tuned to balance them. They are the correctly-used anchor for the failure modes above. ↩