Inside the CCP: Triage, Treat, and Move with Purpose
Introduction: The CCP Is Not the End—It’s the Through Line
Casualty Collection Points (CCPs) are often misunderstood. In many response plans, they’re treated as fixed medical zones or ad hoc field hospitals. This misunderstanding leads to cluttered spaces, delayed evacuations, and unnecessary interventions. But here’s the truth: a CCP is not a destination—it’s a conduit.
Inside the CCP, speed is survival. The role of Medical Rescue Teams (MRTs), fire/EMS, and law enforcement is not to deliver prolonged care but to triage, treat, and move. The mission is to provide only what is necessary to get casualties to definitive care—and to do it as efficiently and safely as possible.
CCPs function best when they are clean, calm under pressure, and clearly oriented toward evacuation readiness. It is not a place to linger. It is not a place to experiment with care. It is the place where life-saving decisions are made with precision, under time constraints, and in dynamic, often high-threat environments.
The CCP’s True Purpose: Transition, Not Treatment
A CCP is a tactical medical staging area, typically located within the warm zone but can be in the hot zone at times—close enough to the point of injury for rapid access, but secured enough for focused triage and stabilization. The purpose of the CCP is to provide rapid sorting and life-saving interventions that allow for safe movement of casualties to higher levels of care.
It is a fluid environment, not a static one. The goal is to prevent the CCP from becoming a choke point. Think of it like a trauma assembly line—each patient is assessed, stabilized to the level necessary for safe evacuation, and quickly transferred out of the hot zone.
CCPs succeed when responders:
Maintain control of casualty flow
Apply only immediate life-saving interventions (LSIs)
Avoid over-treatment
Reassess frequently
Prioritize movement
If your CCP turns into a treatment bay, your system has stalled.
The Triage Process: Fast, Focused, and Repetitive
The triage process inside the CCP must be fast, standardized, and repeatable. Multiple systems may be employed depending on agency preference or patient population, but they must be trained, coordinated, and clearly understood across all teams.
Common Triage Models Used in CCPs:
START (Simple Triage and Rapid Treatment): Adult triage based on respiratory effort, perfusion, and mental status (RPM).
JumpSTART: Pediatric version of START, adapted for developmental and physiological differences in children.
MARCH (Massive Hemorrhage, Airway, Respiration, Circulation, Hypothermia/Head Injury): Tactical trauma assessment focused on preventable death priorities.
The goal is to sort and treat. Patients are classified as Immediate (Red), Delayed (Yellow), Minimal (Green), or Expectant/Deceased (Black), and tagged accordingly.
Reassessment is critical. Just because a patient is initially classified as Yellow doesn’t mean they’ll stay that way. CCP teams must continuously cycle through patients, especially during prolonged operations or transport delays.
Treatment Priorities: Only What’s Needed to Move
MRTs inside the CCP must operate with the mindset of “treat only to move.” This means performing interventions that are immediately life-saving and essential for survival during transport:
M – Massive Hemorrhage: Tourniquet application, wound packing
A – Airway: Positioning, airway adjuncts
R – Respirations: Chest seals, tension pneumothorax identification
C – Circulation: Shock recognition, fluid resuscitation protocols
H – Hypothermia & Head Injury: Early insulation, neurologic assessment
If an intervention doesn’t directly enable survival to transport or prevent imminent deterioration, it should wait. The CCP is not the place for IV lines, fluid administration (unless critical), or medication delivery unless the casualty is crashing.
Over-treatment in the CCP is a trap. It wastes time, clutters the area, and delays evacuation—ultimately increasing mortality.
Evacuation Readiness: The End Goal of Every CCP
The most important function of the CCP is not care—it’s movement. Every action taken inside the CCP must move casualties closer to the ambulance, the trauma center, or the OR. This requires:
Clear evacuation lanes: Physical routes for stretchers and litters, unobstructed and secured.
Transport coordination: Close contact with EMS staging officers and command staff to request and direct assets.
Casualty tracking: Maintain accurate logs of patient status, triage category, and transport destinations. Use triage tags, whiteboards, or digital tools as available.
Preloading patients: Bundle supplies, secure dressings, and ensure patients are transport-ready before the vehicle arrives.
Patient flow should be intentional and continuous. Casualties should never stack up inside the CCP. If they do, it's a red flag that evacuation is stalled or that over-treatment is slowing the process.
Personnel Management: Know Your Roles
The CCP only works if everyone inside it knows their job. That includes MRTs, EMS personnel, law enforcement, and any assisting volunteers. Key roles include:
Triage Officer: Identifies and categorizes patients on arrival.
Treatment Team: Performs LSIs and preps for movement.
Evacuation Coordinator: Communicates with EMS and command to manage outgoing transport.
Scribe/Tracker: Maintains a log of all patients, interventions, reassessments, and movements.
Security Liaison: Works with law enforcement to maintain corridor safety and prevent unauthorized access.
Role clarity eliminates chaos. Every second wasted figuring out who’s in charge or what the plan is could be a second closer to patient deterioration.
The Physical CCP: Setup and Environment
A well-functioning CCP is more than a cleared hallway. It should have:
Defined entry and exit lanes
Cover and concealment if in a high-threat environment
Adequate lighting (natural or artificial)
Basic supplies pre-staged (tourniquets, dressings, triage tags)
Patient organization zones by triage category
Space management is critical. Keep Red and Yellow patients accessible and close to exit routes. Green patients can assist if stable, but they must not block access. Black tags must be respectfully moved out of the primary workflow area.
Common Mistakes Inside the CCP—and How to Avoid Them
Overloading the CCP: If patients aren’t moving out, you’re not functioning—you’re collecting.
Treating instead of triaging: Sorting comes first. If you're skipping triage to begin treatment, your workflow is broken.
No reassessment: Initial classifications are just that—initial. Reassess every 10–15 minutes or as conditions change.
Poor communication: No updates to command or transport units lead to backups and delays.
Gear overload: CCPs should be stocked, not stuffed. Excess equipment slows work and creates confusion.
Conclusion: Purpose Over Comfort
The CCP is not a comfort zone. It’s not a place for long-term care. It is a controlled chaos space where the goal is movement, not medicine. The faster patients are assessed, stabilized, and moved out, the better their chance of survival.
If MRTs and CCP teams treat the space as a trauma bay, they will lose patients. If they treat it as a launchpad to higher care, they’ll save them. The power of the CCP lies not in its duration—but in its precision and purpose.
Train to move. Treat to evacuate. Triage like it matters—because it does.
