START Adult Triage Algorithm: Text Version

• Page graphics illustrate 2 concepts:
  • 4 distinct clinical triage categories for mass casualty patients, with each category assigned a distinct name and color
  • One algorithm suggesting how to triage patients into these 4 categories
• How this information would be used in a mass casualty event:
  • Emergency first clinical responders would follow the clinical algorithm to evaluate each patient and assign a triage category and color based on various clinical parameters. The information would be noted on the triage tag attached to the mass casualty victim.
  • Rescuers following after the triage officer would view the color and text of the triage tag and take appropriate action.
• Clinical parameters used to evaluate patients include:
  • Ability to walk
  • Presence or absence of spontaneous breathing
  • Respiratory rate greater or less than 30 per minute
  • Perfusion assessment using either the palpable radial pulse or visible capillary refill rate
  • Mental status as assessed by ability to obey commands.
• The 4 conventional triage categories are:
  • Minor: Green Triage Tag Color
    • Victim with relatively minor injuries
    • Status unlikely to deteriorate over days
    • May be able to assist in own care: also known as "walking wounded"
  • Delayed: Yellow Triage Tag Color
    • Victim's transport can be delayed
    • Includes serious and potentially life-threatening injuries, but status not expected to deteriorate significantly over several hours
  • Immediate: Red Triage Tag Color
    • Victim can be helped by immediate intervention and transport
    • Requires medical attention within minutes for survival (up to 60 minutes)
    • Includes compromise to patient's airway, breathing, and circulation (the ABC's of initial resuscitation)
  • Expectant: Black Triage Tag Color
    • Victim unlikely to survive given severity of injuries, level of available care, or both
    • Palliative care and pain relief should be provided