Triage systems are crucial in mass casualty incidents, helping responders quickly sort patients based on severity. START and JumpSTART methods assess key factors like walking ability and breathing to categorize adults and children, ensuring efficient resource allocation.
Color-coded tags and reverse triage further streamline patient management. These systems embody the core principle of mass casualty response: doing the greatest good for the most people with limited resources.
Triage Systems
START and JumpSTART Triage
- START (Simple Triage and Rapid Treatment) triage system used for adults in mass casualty incidents
- Assesses ability to walk, respiratory rate, and perfusion to categorize patients
- JumpSTART triage system adapted from START for use with pediatric patients
- Considers different physiological parameters and developmental stages of children
- Both systems aim to quickly sort patients based on severity and prioritize treatment
- Color-coded triage tags used to visually identify patient categories (red, yellow, green, black)
- Tags provide quick reference for patient status and priority level
- Reverse triage process of assessing patients already admitted to healthcare facilities
- Determines which patients can be safely discharged or transferred to make room for incoming casualties
- Helps optimize resource allocation during mass casualty events
Mass Casualty Triage Principles
- Mass casualty triage differs from day-to-day triage in scale and resource limitations
- Goal is to do the greatest good for the greatest number of patients
- Focuses on rapidly assessing and categorizing patients based on severity
- May involve difficult decisions about allocating limited resources
- Requires a systematic approach and clear communication among responders
Triage Categories
Primary and Secondary Triage
- Primary triage initial rapid assessment of patients at the scene of an incident
- Quickly categorizes patients based on severity and treatment priority
- Secondary triage more detailed assessment performed once patients have been evacuated to a treatment area
- Provides a more comprehensive evaluation of injuries and treatment needs
- Both stages are crucial for effectively managing mass casualty incidents
Triage Category Definitions
- Immediate (red) life-threatening injuries requiring immediate intervention (airway obstruction, severe bleeding)
- Delayed (yellow) serious injuries that can wait for treatment (fractures, moderate burns)
- Minimal (green) minor injuries that can be self-treated or delayed (abrasions, sprains)
- Expectant (black) unlikely to survive due to severity of injuries or lack of resources
- Categories help prioritize treatment and resource allocation based on patient needs
Overtriage and Undertriage
- Overtriage occurs when patients are assigned to a higher priority category than necessary
- Can lead to overutilization of limited resources on less severe cases
- Undertriage occurs when patients are assigned to a lower priority category than required
- Can result in delayed treatment for severe cases and potentially worse outcomes
- Balancing overtriage and undertriage is a challenge in mass casualty incidents
- Triage systems aim to minimize both while ensuring the most critical patients receive timely care