It describes the critical review of a translational triage research and development instrument designed to facilitate the development of standardized pre-hospital triage decision-making systems in mass casualty incidents (MCI). The tool aims to enhance the reliability and practicality of the sorting procedures for emergency response service providers in a situation with a more significant number of patients. Based on a comprehensive literature review, the research addresses the years of evolution of pre-hospital triage systems, recalls the key challenges that are faced by current triage practices, and projects the implications of the research tool for the increased accuracy of triage making. The article presents the methodology, describes the outcomes and findings from real-life field studies, and suggests potential research and clinical perspectives for future studies. Accordingly, recommendations to incorporate the tool into mass casualty triage emergency protocols and move the research field forward are stated.