START Triage • First - clear the walking wounded using verbal instructions. – Direct them to the treatment areas for detailed assessment and treatment...
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Simple Triage And Rapid Treatment
START Triage
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 • Respiration's – None - Open the Airway • Still None? - DECEASED • Restored?- IMMEDIATE
START Triage • Perfusion – Radial Pulse Absent or Capillary Refill > 2 secs IMMEDIATE – Radial Pulse Present or Capillary Refill < 2 secs CHECK MENTAL STATUS
RPM
START Triage • Mental Status – Can Not Follow Simple Commands (Unconscious or Altered LOC) IMMEDIATE – Can Follow Simple Commands DELAYED
RPM
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 All Walking Wounded MINOR
RESPIRATIONS Yes
No
Over 30/min
Under 30/min
IMMEDIATE
PERFUSION Radial Pulse Absent Control Bleeding IMMEDIATE
Position Airway
Capillary Refill Over 2 seconds
Radial Pulse Present Under 2 seconds
Yes
No
IMMEDIATE
DECEASED
MENTAL STATUS
Can't Follow Simple Commands
Can Follow Simple Commands
IMMEDIATE
DELAYED
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 the Newport Beach (CA.) Fire & Marine Department PowerPoint Program Modified by Lt. S. Albright – SC-EMS.com