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START Adult Triage Algorithm: Text Version
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Page graphics illustrate 2 concepts:
- 4 distinct clinical triage categories for mass casualty patients, with each category assigned a distinct name and color
- One algorithm suggesting how to triage patients into these 4 categories
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How this information would be used in a mass casualty event:
- Emergency first clinical responders would follow the clinical algorithm to evaluate each patient and assign a triage category and color based on various clinical parameters. The information would be noted on the triage tag attached to the mass casualty victim.
- Rescuers following after the triage officer would view the color and text of the triage tag and take appropriate action.
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Clinical parameters used to evaluate patients include:
- Ability to walk
- Presence or absence of spontaneous breathing
- Respiratory rate greater or less than 30 per minute
- Perfusion assessment using either the palpable radial pulse or visible capillary refill rate
- Mental status as assessed by ability to obey commands.
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The 4 Triage Categories are:
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Minor: Green Triage Tag Color
- Victim with relatively minor injuries
- Status unlikely to deteriorate over days
- May be able to assist in own care: also known as "walking wounded"
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Delayed: Yellow Triage Tag Color
- Victim's transport can be delayed
- Includes serious and potentially life-threatening injuries, but status not expected to deteriorate significantly over several hours
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Immediate: Red Triage Tag Color
- Victim can be helped by immediate intervention and transport
- Requires medical attention within minutes for survival (up to 60 minutes)
- Includes compromise to patient's airway, breathing, and circulation (the ABC's of initial resuscitation)
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Expectant: Black Triage Tag Color
- Victim unlikely to survive given severity of injuries, level of available care, or both
- Palliative care and pain relief should be provided
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Minor: Green Triage Tag Color