Triage at Mass Casualty Incidents Using START

Study Notes

Triage at Mass Casualty Incidents (MCI) using START Algorithm

Overview of Triage

Triage is the process of prioritizing patients based on the severity of their conditions.
In mass casualty incidents, resources may be limited, necessitating efficient patient categorization.

START Algorithm (Simple Triage and Rapid Treatment)

Developed for rapid assessment and sorting of patients.
Focuses on identifying patients who need immediate treatment to maximize survival.

Triage Categories

Immediate (Red Tag)
- Life-threatening injuries requiring immediate intervention.
- Examples: airway obstruction, severe bleeding, shock.
Delayed (Yellow Tag)
- Serious injuries that are not immediately life-threatening.
- Require timely care but can wait without significant risk of deterioration.
- Examples: fractures, moderate burns.
Minimal (Green Tag)
- Minor injuries that do not require immediate medical attention.
- Patients can assist in their own care.
- Examples: small lacerations, minor abrasions.
Expectant (Black Tag)
- Patients unlikely to survive given the severity of their injuries and limited resources.
- Focus on comfort measures.
- Examples: traumatic brain injury, extensive burns.

Triage Process

Initial Assessment
- Quickly assess the patient’s ability to walk, breath, and circulation.
- Use the "30-2-can do" rule:
  - Breathing: Check if they are breathing; if not, clear the airway (if possible).
  - Circulation: If no pulse, consider as expectant (Black).
  - Mental Status: Ask the patient to walk, if they can, they are likely a Green tag.
Assessment Steps
- Breathing:
  - If breathing > 30 breaths/min or not breathing after airway clearance → Red.
  - If breathing < 30 breaths/min → Check circulation.
- Circulation:
  - No pulse → Red (Immediate).
  - Pulse present → Assess mental status.
- Mental Status:
  - If conscious and follows commands → Yellow (Delayed).
  - If not responding → Red (Immediate).
Reassessment
- Continuously monitor and adjust triage tags as needed based on patient condition and available resources.

Key Considerations

Communicate clearly with all responders.
Use a systematic approach to ensure no patient is overlooked.
Provide clear documentation for each patient’s status.
Be adaptable; re-evaluation is essential as the situation evolves.

Conclusion

Effective triage at MCIs using the START algorithm can save lives by ensuring timely care for those most in need.

Overview of Triage

Prioritizes patients according to injury severity, essential during mass casualty incidents where resources are limited.

START Algorithm

A framework for quick patient assessment and sorting aimed at maximizing survival rates.

Triage Categories

Immediate (Red Tag):
- Life-threatening injuries requiring prompt care, such as airway obstruction and severe bleeding.
Delayed (Yellow Tag):
- Serious but not immediately life-threatening injuries that can safely wait, e.g., fractures and moderate burns.
Minimal (Green Tag):
- Minor injuries that do not need urgent attention; patients can aid their own care, such as small lacerations.
Expectant (Black Tag):
- Patients unlikely to survive given their injury severity; focus on comfort measures, includes extensive burns and traumatic brain injuries.

Triage Process

Initial Assessment:
- Evaluate walking ability, breathing, and circulation using the "30-2-can do" rule.
Assessment Steps:
- Breathing:
  - Breathing rate > 30 breaths/min or not breathing → Red.
  - Breathing < 30 breaths/min → proceed to check circulation.
- Circulation:
  - No pulse → Red (Immediate).
  - Presence of pulse → assess mental status.
- Mental Status:
  - Conscious and responsive → Yellow (Delayed).
  - Unresponsive → Red (Immediate).
Reassessment:
- Continuously monitor and update triage tags based on evolving patient conditions and resource availability.

Key Considerations

Clear communication amongst responders is crucial.
A systematic approach ensures all patients are accounted for.
Document each patient’s status clearly for effective management.
Adaptability is vital as conditions may change during incidents.

Conclusion

Utilizing the START algorithm in mass casualty incidents enhances the likelihood of survival by prioritizing timely treatments for the most critical patients.

Description

This quiz explores the principles of triage in mass casualty incidents using the START algorithm. Understand the categorization of patients based on the urgency of their medical needs, including immediate, delayed, and minimal cases. Test your knowledge on effective patient prioritization techniques.