START Triage

SimpleTriageAndRapidTreatment

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 Presentor

Capillary Refill < 2 secsCHECK MENTAL STATUS

START Triage RPM

• Mental Status– Can Not Follow Simple Commands

(Unconscious or Altered LOC)IMMEDIATE

– Can Follow Simple CommandsDELAYED

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

ControlBleeding

Radial PulseAbsent

Over 2seconds

Under 2seconds

CapillaryRefill

IMMEDIATE

Can't FollowSimple Commands

DELAYED

Can FollowSimple Commands

MENTAL STATUS

Radial PulsePresent

PERFUSION

Under 30/min

Yes

IMMEDIATE

Yes

DECEASED

No

Position Airway

No

RESPIRATIONS

All WalkingWounded

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 theNewport Beach (CA.)

Fire & Marine Department

PowerPoint Program Modified by Lt. S. Albright – SC-EMS.com