Post on 27-Mar-2015
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 ConsortiumMedical Command
Triage Treatment Transport
Primary Triage
Tertiary Triage
Secondary Triage
Speed
Accuracy
Organization
3 Assessments
VentilationPerfusionCognition
2 TreatmentsAirway MaintenanceHemorrhage Control
RESPIRATION
NONE YES
REPOSITION AIRWAY
ASSESS RESPIRATIONS/VENTILATION
NONE
DECEASED
YES
IMMEDIATE
< 30/MINUTEASSESS
PERFUSION
> 30/MINUTE
IMMEDIATE
PERFUSION
< 2 SECONDSASSESS
MENTAL STATUS
> 2 SECONDSCONTROL BLEEDING
IMMEDIATEED
MENTAL STATUS
FOLLOWS SIMPLECOMMANDS
DELAYED
FAILS TO FOLLOWSIMPLE COMMANDS
IMMEDIATE
RESPIRATIONS/VENTILATION
NONE YES
REPOSITION AIRWAY
ASSESS RESPIRATIONS/VENTILIATION
NONE
DECEASED
YES
IMMEDIATE
< 30/MINUTEASSESS
PERFUSION
> 30/MINUTE
IMMEDIATE
PERFUSION
< 2 SECONDSASSESS
MENTAL STATUS
> 2 SECINDSCONTROLBLEEDING
IMMEDIATE
MENTAL STATUS
FOLLOWSSIMPLE
COMMANDS
FAILS TO FOLLOWSIMPLE
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
Age Heart Rate Systolic BP RespirationNewborn 100-160 50-70 30-60
1-6 weeks 100-160 70-95 30-606 months 90-120 80-100 25-40
1 year 90-120 80-100 25-403 years 80-120 80-110 20-306 years 70-120 80-110 18-25
10 years 60-90 90-120 15-20
Exercise Objectives
• Rapid and accurate application of START Triage during an MCI