S T A R T Triage S T

S. T. A. R. T. Triage S. T. A. R. T. Logo and Algorithm reprinted with permission of Hoag Memorial Hospital Presbyterian and Newport Beach Fire Department.

Course Objectives • Define MCI • Describe Levels of On-scene Triage for MCI • Describe the Use and Purpose of START Triage as an Initial Triage System • Describe the Accepted Use of START Triage Tags

MCI Multi Casualty Incident • An accident or emergency that overwhelms local response capability

ICS • Creates and provides for compatibility and integration of all responding agencies

ICS Incident Command System • Structural approach to emergency response – Personal Roles – Lines of Authority – Effective Communication

MCI? • Multi Casualty Incident • Mass Casualty Incident • MVI Multi or Mass Victim Incident

Field Triage Accomplish the greatest medical good for the greatest number of people

Effective Field Triage • • Medically responsible Rapid Simple Smooth Transitions

Field Triage Consortium Medical Command Triage Treatment Transport Primary Triage Secondary Triage Tertiary Triage

Speed Accuracy Organization

3 Assessments Ventilation Perfusion Cognition 2 Treatments Airway Maintenance Hemorrhage Control

RESPIRATION NONE YES REPOSITION AIRWAY ASSESS RESPIRATIONS/VENTILATION NONE YES DECEASED IMMEDIATE < 30/MINUTE ASSESS PERFUSION > 30/MINUTE IMMEDIATE PERFUSION < 2 SECONDS ASSESS MENTAL STATUS > 2 SECONDS CONTROL BLEEDING IMMEDIATEED MENTAL STATUS FOLLOWS SIMPLE COMMANDS DELAYED FAILS TO FOLLOW SIMPLE COMMANDS IMMEDIATE

RESPIRATIONS/VENTILATION NONE YES REPOSITION AIRWAY ASSESS RESPIRATIONS/VENTILIATION NONE DECEASED YES IMMEDIATE < 30/MINUTE ASSESS PERFUSION > 30/MINUTE IMMEDIATE

PERFUSION < 2 SECONDS ASSESS MENTAL STATUS > 2 SECINDS CONTROL BLEEDING IMMEDIATE

MENTAL STATUS FOLLOWS SIMPLE COMMANDS FAILS TO FOLLOW SIMPLE COMMANDS DELAYED IMMEDIATE

START WHERE YOU STAND

Walking Wounded

Primary Triage • Rapid patient assessment and tagging • Immediate live sustaining care, as necessary

Secondary Triage • Document, reassess and sort patients by treatment needs • Provide medical treatment as appropriate and available

Tertiary Triage • Reassess condition of patients relevant to resources, transportation and medical facilities • Determine priority for disposition of patients from incident site

Normal Pediatric Vital Signs

Exercise Objectives • Rapid and accurate application of START Triage during an MCI