2013 OEC Refresher
Station 2 – Self Guided Review
Two Part Review

Section One: START Triage System

Section Two: Triage Tag Completion
Simple
Triage
And
Rapid
Treatment
START Triage System
Prepared By Ken Young ; Office of Education and Certification - MIEMSS - 1999
START




Rapid approach to triaging large numbers of
causalities
Initial patient assessment and treatment should
take less than 30 seconds for each patient
Easy to remember
START right where you are. At the first patient
you come to, not the worst patient you may
see.
START

First - clear the walking wounded using verbal
instructions.
– Direct them to the treatment areas for detailed
assessment and treatment
– Tag These as MINOR

Now check your RPMs
START

Respiration's
– None - Open the Airway
 Still None? - DECEASED
 Restored?- IMMEDIATE
– Present?
 Above 30 - IMMEDIATE
 Below 30 - CHECK PERFUSION
RPM
START

Perfusion
– Radial Pulse Absent
or
Capillary Refill > 2 secs
IMMEDIATE
– Radial Pulse Present
or
Capillary Refill < 2 secs
CHECK MENTAL STATUS
RPM
START

Mental Status
– Can Not Follow Simple Commands
(Unconscious or Altered LOC)
IMMEDIATE
– Can Follow Simple Commands
DELAYED
RPM
START
Exceptions:
* Co- Workers
* Emotional Disorder (uncontrollable)
Both above get automatically labeled as
IMMEDIATE
START
If patient is immediate - priority 1 upon initial
assessment, attempt to correct airway
blockage or uncontrolled bleeding only before
moving on to next patient.
START
The START process permits a very few rescuers
to rapidly triage a large number of patients
without specialized training.
ONLY After patients are moved to treatment
areas where more detailed assessment and
treatment are conducted.
START

When things get hectic with multiple patients
rev up your RPM’s.
–R - Respiration - 30
–P - Perfusion - 2
–M - Mental status - CAN do
“30 – 2 – CAN do”
Section Two:
Triage Tags

Rip off numbered
Triage Status

Body Diagram

Vitals / AVPU

Patient Name

Notes/ Treatment

Transport Record

On back : Injury /
Chief Complaint
Triage Status Section
– Perforated Tabs to rib off to correct
Pt. status.
– Remove the upper tabs that are not
appropriate for this Pt. Thus, the
top off the existing tag shows the
color status for this Pt. condition.
– If Pt. status deteriorates can rip off
to next status.
– Note: Each tag is sequentially
number to track all Patients
Diagram - Chief Complaint Section



Major obvious injuries or illness
should be checked off on body
part of Human Figure for quick
reference on front of Tag.
More detail description to be
written in on back of tag.
Multiple injuries - mark figure
with “A” “B” and “C” to cross
reference description details on
back.
Vitals - APVU


Initial Triage to include
Time, Pulse, Resp. and
AVPU.
Balance of items can be
filled at time of
treatment or second
triage.
Patient Information Section


Again, during MCIs this information is not always
obtainable.
Some information is not a priority, can be added
throughout triage, treatment, transportation, and
hospital reception phases.
Jim-Bob Rumplestillskin
Notes / Treatment



Pertinent items such as SAMPLE and other history.
Any treatment done on this patient with time.
Please write legible and small as notes will
invariably added by others at a later date.
Additional sets of vital can also be recorded here.
Transportation Record Section (front)



Detachable by tear-off bottom of ticket
Used to document patients removed from the scene
to a hospital or other facility
Make certain unit, Injury, priority, depart time and
destination is marked. Use the column with the
appropriate priority color to write in the
information.
HOSP NOTIFIED
Transportation Record Section (back)


On the back of the tag that you detached has
additional comments section. Fill in pertinent
information and treatment to date.
Transportation record to be given to Transportation
officer so he/she can track and log every tag number
(Patient).
HOSP NOTIFIED
Injuries – Chief Complaint



Notes of injuries to Patient.
Fill in the under the
appropriate Triage (color)
you have assigned.
Written notes here should
match what you have
checked of on the human
diagram on the front.
PROGRAM SUMMARY

Triage tag allows for continuous:
– Triage assessments of patient
– Patient information recording
– Patient accountability & tracking
PROGRAM SUMMARY

One Tag = One Patient
– Tags are not interchangeable, as each possesses a
unique number
– Tags cannot be ‘thrown away’ -- All tags need to
be accounted for at end of the incident.
– Do not altered previous notes on a tag; add to it
as necessary.
– Pick-up Any Loose Tags and Report Them to
Treatment Unit Coordinator
PROGRAM SUMMARY
Establishing
The System Of Patient
Triage, Treatment, and Tracking Early
in Any Multi Casualty Incident Is the
Key to Effectively Coordinating Patient
Flow
Program Summary
Incident Site
Priority Red Patients
Treatment Unit
Coordinator
Morgue
Priority Yellow Patients
Priority Green Patients
North Hospital
South Hospital
Transportation Group Supervisor
East Hospital
Transport Unit
West Hospital
Staging
Disposition and
Medical Communications
Perfect Practice Makes Perfect
Practice the Use of These Procedures in
Mock Situations, Before
You Really Need It