Zaragoza National High School Red Cross Youth

Council
Immediate (I): Victim has life-
threatening injuries (airway,
bleeding, or shock)
Delayed (D): Injuries do not
jeopardize victims life; treatment
can be delayed
Minor (M): Walking wounded and
generally ambulatory
Dead (DEAD): No respiration after
two attempts to open airway
Provide greatest good for
greatest number
by conducting simple
triage
and rapid treatment
START SYSTEM
STart = Simple Triage
Victims sorted based on priority of
treatment

stART = And Rapid Treatment
Rapid treatment of injuries assessed
and prioritized in first phase
START SYSTEM

START First Step
Can the Patient Walk?
YES NO
Green
(Minor)
Evaluate
Ventilation
(Step-2)
START Step-2
Ventilation Present?
YES
NO
> 30/Min
< 30/min
Evaluate Circulation
(Step-3)
Open Airway
Ventilation Present?
NO
YES
Black
Red/ Immediate
Red/ Immediate
START Step-3
Circulation
Absent Radial Pulse
Control Hemorrhage
Present Radial Pulse
Evaluate Level of
Consciousness
Red/ Immediate
START Step-4
Cant Follow Simple
Commands
Level of Consciousness
Can Follow Simple
Commands
Yellow/ Delayed
Red/ Immediate
Contaminated Patients
Patients with exposure (potential or
real) to contaminants should be tagged
as BLUE
This category will continue to stay until
patient is adequately decontaminated
then follow START as usual
Some recommend a double tagging
with blue and the standard START color
Remember RPM
R- Respirations- 30
P- Perfusion- Radial Pulse
M- Mental- Follows Commands
START-Overview
Importance of Quick Action
Phase 1: Death within minutes, result of
severe trauma
Phase 2: Death within several hours, result
of excessive bleeding
Phase 3: Death in several days or weeks,
result of infection
CERT Training
Treatment for life-threatening conditions
Airway obstruction, bleeding, shock
Treatment for other, less urgent conditions

Provide greatest good for greatest number
by conducting simple triage
and rapid treatment
Three Killers
Emergency medicine killers
Airway obstruction
Bleeding
Shock
First priority of medical operations:
Open airway
Control excessive bleeding
Treat for shock
How to Approach a Victim
Be sure victim can see you
Identify yourself
Your name and name of your organization
Request permission to treat, if possible
Respect
cultural differences
Open the Airway

Open vs. Obstructed Airway

Head-Tilt/Chin-Lift Method

Types of Bleeding - 1
Arterial bleeding
Bleeding from artery spurts
Venous bleeding
Bleeding from vein flows
Capillary bleeding
Bleeding from capillaries oozes
Types of Bleeding - 2

Control Bleeding
3 main methods for controlling bleeding:
Direct pressure
Elevation
Pressure points
Pressure Points

Shock
Result of ineffective circulation of blood
Remaining in shock will lead to death of:
Cells
Tissues
Entire organs

Conclusions
Triage is a method of quickly identifying
victims who have immediately life-
threatening injuries AND who have the
best chance of surviving
Key elements of the START Triage
System are: Respiration, Perfusion and
Mentation
Reverse Triage is used for mass casualty
lightning incidents.



END