I go to USUHS where the triage stuff is mostly taught Army style. I’ve also been in the Navy for 7 years involved in TCCC and CLS, so I have a little experience (though less with the Army). We don’t triage exclusively by severity of injury. Let me clarify. When I say we go by survivability, what I mean is that we triage people based on the severity of injury and whether or not they are expected to survive.
If you have 3 patients from a IED, and one of them has minor trauma, one has a lower extremity amputation but is otherwise stable, and one of them has bilateral extremity amputations plus a distended abdomen, unstable pelvis, is unresponsive and is not responding to a fluid challenge with no peripheral pulses and a barely palpable pulse in the carotids and extremely shallow breathing, and maybe some seizing from late stage hemorrhaging, that third patient might be more severely injured, but they are probably not surviving the trip. You’re sending that stable lower leg amp back first because they will survive the trip and have a shot at surviving. Patient three will be lucky to survive for a few more minutes in a BAS.
It is similar to the civilian world but not identical. In the civilian world you typically don’t have to worry about blast injuries, nor are you essentially evacing every patient out of your aid station because you don’t have the capability to do much more than a surgical airway, chest tubes, and give some blood. Survivability and resource management becomes more of an issue in a deployed setting.
And I’m not the one who said ethical calculus comes into play. I said it doesn’t and triaging based on who “deserves” it more is ridiculous.