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S.T.A.R.T. Triage S.T.A.R.T. Logo and Algorithm reprinted with permission of Hoag Memorial Hospital Presbyterian and Newport Beach Fire Department.
Course Objectives Define MCI Describe Levels of On-scene Triage for MCI Describe the Use and Purpose of START Triage as an Initial Triage System Describe the Accepted Use of START Triage Tags
MCI Multi Casualty Incident An accident or emergency that overwhelms local response capability
ICS Creates and provides for compatibility and integration of all responding agencies
ICS Incident Command System Structural approach to emergency response –Personal Roles –Lines of Authority –Effective Communication
MCI? Multi Casualty Incident Mass Casualty Incident MVI Multi or Mass Victim Incident
Field Triage Accomplish the greatest medical good for the greatest number of people
Effective Field Triage Medically responsible Rapid Simple Smooth Transitions
Field Triage Consortium Medical Command TriageTreatmentTransport Primary Triage Tertiary Triage Secondary Triage
Speed Accuracy Organization
3 Assessments Ventilation Perfusion Cognition 2 Treatments Airway Maintenance Hemorrhage Control
RESPIRATION NONEYES REPOSITION AIRWAY ASSESS RESPIRATIONS/VENTILATION NONE DECEASED YES IMMEDIATE < 30/MINUTE ASSESS PERFUSION > 30/MINUTE IMMEDIATE PERFUSION < 2 SECONDS ASSESS MENTAL STATUS > 2 SECONDS CONTROL BLEEDING IMMEDIATEED MENTAL STATUS FOLLOWS SIMPLE COMMANDS DELAYED FAILS TO FOLLOW SIMPLE COMMANDS IMMEDIATE
RESPIRATIONS/VENTILATION NONEYES REPOSITION AIRWAY ASSESS RESPIRATIONS/VENTILIATION NONE DECEASED YES IMMEDIATE < 30/MINUTE ASSESS PERFUSION > 30/MINUTE IMMEDIATE
PERFUSION < 2 SECONDS ASSESS MENTAL STATUS > 2 SECINDS CONTROL BLEEDING IMMEDIATE
MENTAL STATUS FOLLOWS SIMPLE COMMANDS FAILS TO FOLLOW SIMPLE COMMANDS DELAYED IMMEDIATE
START WHERE YOU STAND
Primary Triage Rapid patient assessment and tagging Immediate live sustaining care, as necessary
Secondary Triage Document, reassess and sort patients by treatment needs Provide medical treatment as appropriate and available
Tertiary Triage Reassess condition of patients relevant to resources, transportation and medical facilities Determine priority for disposition of patients from incident site
Normal Pediatric Vital Signs
Exercise Objectives Rapid and accurate application of START Triage during an MCI
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