1.
TRIAGE DEFINITION
Triage: comes from the French word trier, which means "to sort;” A method to
quickly evaluate and categorize the patients requiring the most emergent medical
attention.
Triage is the process of prioritizing or sorting sick or injured people for treatment
according to the seriousness of the condition or injury.
Primary and Secondary Triage
● Primary triage
1st contact
Assign triage category
● Secondary triage
an ongoing process that takes place after the patient has been moved to the
treatment/holding area awaiting transport.
Triage Categories
Red (1)= immediate - critical patient
Yellow (2)= delayed - serious a patient that could wait until all reds have been
transported
Green(3) = ambulatory / hold –minor injuries
Black = deceased (expectant)
2. STATE THE DYNAMICS OF START TRIAGE- Simple Triage And Rapid Treatment
The “START” System of Triage Simple triage and rapid treatment START) is a triage
method used by first responders to quickly classify victims during a mass casualty
incident (MCI) based on the severity of their injury.
START triage is a scene management system. Its very effective for mass casualty
incidents. Like many aspects of emergency prehospital management, you don't get
much advance warning. You may go your whole career and never have an MCI.
Then, one day, after breakfast, you are the first on the scene of a 25-car pileup. So,
we need a SIMPLE system that we can stuff into our brains that doesn't take up a lot
of room. START triage is that system.
The method was developed in 1983 by the staff members of the Newport Beach Fire
Department located at Hoag Memorial Hospital in Newport Beach, CA
● Easy to use
● Focus is on signs/symptoms
● Fast
START – 4 things to think about…
● Ability to follow directions and walk
● Respiratory effort
● Pulses/perfusion
● Mental status
The “START” System of Triage using START Triage, evaluate victims and assigns them to
four categories:
1. Walking wounded/minor (green)
2. Delayed (yellow)
3. Immediate (red)
4. Deceased/expectant (black)
“START” Focus on tagging the patients
● BEGIN -Clear out all ambulatory patients – tag Green
● Rest of the patients require MORE triage – 3 steps: They will be either red, yellow or
black.
○ Respiratory effort
○ Pulses/perfusion
○ Mental status
The “Greens”
● Once they walk toward you – designate a place for them to go
● Someone needs to tag them green
● Someone needs to stay with them & keep them informed
Something To Think About…. Keep in mind that in a larger scale event, patients may be
spread out over a large area or even on several floors or rooms in a building. In this type of
situation, you may encounter further ambulatory patients as you progress. They are still
tagged green – direct them to the area that you selected for the “greens” to stage.
START – Step 1 Respiratory Effort
Not breathing – manually open their airway
If they start breathing - tag RED
If they don’t start breathing – tag BLACK
Breathing >30 or <10 = tag RED
Breathing normal 10-30 = go to next step
START – Step 2 Pulses/Perfusion
Check for Radial pulse.
Radial pulse absent = tag RED
Radial pulse present = go to next step
START – Step 3 Mental Status
You are assessing whether or not the person can follow a simple command.
“Squeeze my hand”
Can follow a simple command = tag YELLOW
Cannot follow a simple command = tag RED
Triage Tags
Types of triage tags
There are several types of tags on the market QAEMS System uses the SMART Tag.
Advantages of using triage tags
Alerts providers of priorities
Prevents re-triage
Tracking system
3. DISCUSS THE USE OF THE ‘SMART’ TAGGING SYSTEM
Patient Tracking
-Document minimal information depending on your situation
Primary Triage - Very little documentation
Secondary Triage - More information and More assessment and treatment will be
done
-Smart Tag has a command board to keep track of where the patient went.
Reference:
https://www.blessinghealth.org/sites/default/files/users/user15/EMS_START_Triage_SMART
_Tags_2017.pdf
https://drive.google.com/file/d/1KcPfmNncPsiY14kAua9tudzNxvXsKmf4/view
