Mass casualty incident triage

Background

• Used by first responders to quickly classify victims during a mass casualty incident (MCI) based on the severity of their injury

Classification

• Walking wounded/minor (green)
• Delayed (yellow)
• Immediate (red)
• Deceased/expectant (black)

Simple Triage and Rapid Treatment (START)

START triage algorithm

• Able to walk relocate to a certain area (green)
• Non-ambulatory patients are then assessed
  • No respirations → re-position airway
    • No respirations (deceased/expectant)
    • Respirations (immediate)
  • Yes respirations
    • >30/min (immediate)
    • <30 → check perfusion
      • Radial pulse absent OR capillary refill >2 seconds (immediate)
      • Radial pulse present OR capillary refill <2 seconds → check mental status
        • Unable to follow simple commands (immediate)
        • Follows simple commands (delayed)

JumpSTART (Pediatric Patients)

JumpSTART triage algorithm

• Able to walk relocate to a certain area (green)
• Non-ambulatory patients are then assessed
  • No respirations → re-position airway
    • Respirations (immediate)
    • No respirations → check pulse
      • No pulse (deceased/expectant)
      • Yes pulse → 5 rescue breaths
        • Still no respirations (deceased/expectant)
        • Respirations (immediate)
  • Yes respirations
    • <15 or >45/min (immediate)
    • 15-45/min → check perfusion
      • Pulse absent or CRT >2 seconds
        • Control bleeding (immediate)
      • Pulse present or CRT <2 seconds → check mental status
        • Inappropriate (immediate)
        • Appropriate (delayed)

Secondary Assessment of Victim Endpoint (SAVE)

• Applies after patients have been triaged with START/jumpStart
• Designed for appropriation of limited resources for most gain in immediate on-scene care situations
• Three categories:
  • Those who will die regardless of care
  • Those who will survive whether or not they receive care
  • Those who will benefit from limited immediate field interventions

See also

• Mass casualty incidents

Video

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