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Today is a little different.

START Triage System, Mass Emergency Trauma & First Responders Alternate Triage Decision Chart

I am interviewed by another host about the START Triage System, an extremely smart mass casualty triage method. We discuss a neat way to make a smart triage tag, and how it is multi-functional.  The owner of The Survival Podcast.


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  1. Explain what START Triage stands for.

  2. Simple Triage and Rapid Treatment

    1. Simple Triage is first-responder triage, at the scene of a Mass Casualty Incident
      1. Earthquakes

      2. Highway Accidents

      3. Air Crashes

      4. Major Fires

      5. Train Derailments

      6. Building Collapses

      7. Explosions

      8. Terrorist Attacks

      9. Materials Releases

      10. Earthquakes

      11. Tornadoes

      12. Hurricanes

      13. Floods

  1. What is the reason for triage?

    1. process of determining the priority of patients’ treatments based on the severity of their condition
    2. It is a quick way to prioritize injuries to figure out who needs immediate attention and who doesn’t
    3. Triage was used in World War I by French doctors treating wounded at the aid stations. They divided the victims into three categories:
      1. Those likely to live, regardless of what care they get

      2. Those likely to die, regardless of what care they get

      3. Those where immediate care might make a difference in outcome.

    4. Today triage is used to decide how immediate a response the victim needs.


  1. Can you take us through a typical scenario to show us the usefulness of the START system.

    1. Train Accidents
    2. Steps: 
      START Triage System, Mass Emergency Trauma & First Responders Triage Decision Chart

      START Triage System, Mass Emergency Trauma & First Responders Triage Decision Chart (click for larger)

      Chart of Steps

    3. RPM – Respirations, Perfusion, Mental Status
    4. Anyone that can walk out, does so and as they go, you give them a minor tag.
      1. You can keep someone back to help with the next steps.

    5. Check for breathing.  If not breathing, try to adjust airways.
      1. If you can get them to breath, then they need their airway supported and move to next step

      2. If they will not breath, you tag them as deceased.

    6. Pulses/Perfusion: Check their finger nail.  Press down firmly and see if color comes back within 2 seconds.
      1. If so, continue on to next step.

      2. If not, mark them as immediate

      3. Control Major Bleeding

    7. During checking the victims you can check their Mental Status
      1. Ask their names

      2. Ask the day of the week.

      3. Ask them to squeeze your hand.

      4. Things that take just some thought

      5. We verify they can answer us and follow simple direction.

        1. If they can comprehend and answer, we mark them as delayed

        2. If they cannot, we mark them as immediate

      START Triage, the System, Tags, Smart Mass Casualty Triage Method: Triage Tag

      Triage Tag


  1. What does ABC stand for and how does that relate to RPM?

    1. ABC-Airway Breathing Circulation which is for CPR,
    2. RPM-Respiration Perfusion Mental Status which simply means to check the Airway, Circulation, and that they are in their right mind.
    3. As you can tell here that we are essentially checking similar symptoms that we would look at for CPR.


  1. Are there any times in which the START system would cause you to do something that is counter-intuitive to your natural response and , if so, why would you follow the system?

    1. If you have a baby that is not breathing, and will not begin breathing once the airway is cleared, even if a pulse is available, the START method tells you to mark that one as deceased.
    2. The system is simply a suggestion, but it is known to help much more than it hurts.  The idea is to quickly assess everyone and then decide who to begin work on afterward.  The system is over at that point.

    START Triage System, Mass Emergency Trauma & First Responders Kit

  2. Is there any other resources you know of that would be beneficial to the audience?


  3. My Websites



  4. Jack’s Podcast and Blog… check it out.

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Ken is addicted to fitness and mountain biking. He is such a thrill seeker, people are starting to be concerned!He enjoys MTBing, Hiking, Climbing, Geocaching, Orienteering, Weight Lifting, and Wilderness Survival.

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