Emergency Preparedness
START Triage
Simple Triage And Rapid Treatment
START Triage
• Developed in California in the early 1980’s by Hoag Hospital and Newport Beach Fire and Marine (California)
• Rapid approach to triaging large numbers of causalities
• Easy to remember
START Triage
• Initial patient assessment and treatment should take less than 30 seconds for each patient
• Patients are triaged based upon 4 factors – Ability to walk away from the scene – Respiration > or < 30 respirations per minute – Pulse – Radial pulse ? or capillary refill < or > 2 seconds – Mental Status – able/unable to follow simple commands
R espirations P ulse M ental Status
START Triage
• First - clear the walking wounded using verbal instructions. – Direct them to the treatment areas for detailed
assessment and treatment – These Patients are triaged MINOR
• Now check your RPMs
START Triage RPM • Respiration's
– None - Open the Airway • Still None? - DECEASEDDECEASED • Restored?- IMMEDIATE
– Present? • Above 30 - IMMEDIATE • Below 30 - CHECK PERFUSION
START Triage RPM • Perfusion
– Radial Pulse Absent or
Capillary Refill > 2 secs IMMEDIATE
– Radial Pulse Present or
Capillary Refill < 2 secs CHECK MENTAL STATUS
START Triage RPM
• Mental Status – Can Not Follow Simple Commands
(Unconscious or Altered LOC) IMMEDIATE
– Can Follow Simple Commands DELAYED
START Triage
If patient is immediate – Code Red upon initial assessment, attempt only to correct airway blockage or uncontrolled bleeding before moving on to next patient.
START Triage • When things get hectic with multiple patients
rev up your RPM’s. –R - Respiration - 30 –P - Perfusion - 2 –M - Mental status - CAN do
mnemonic: 30 – 2 – CAN DO
START Triage
IMMEDIATE
Over 30/min
IMMEDIATE
Control Bleeding
Radial Pulse Absent
Over 2 seconds
Under 2 seconds
Capillary Refill
IMMEDIATE
Can't Follow Simple Commands
DELAYED
Can Follow Simple Commands
MENTAL STATUS
Radial Pulse Present
PERFUSION
Under 30/min
Yes
IMMEDIATE
Yes
DECEASED
No
Position Airway
No
RESPIRATIONS
All Walking Wounded
MINOR
Respiration's 30
Perfusion 2
Mental Status CAN DO
START Triage
The START process permits a limited number of rescuers to rapidly triage a large number of patients without specialized training.
Patients are systematically moved to treatment areas where more detailed assessment and treatment are conducted.
START Triage
START Triage was Developed by the Newport Beach (CA.)
Fire & Marine Department
PowerPoint Program Modified by Lt. S. Albright – SC-EMS.com