BACKGROUND --

First Responders, Emergency Medical Technicians and Paramedics are trained to handle emergencies. You know how to quickly assess a patient and intervene. But even the best emergency provider is easily overwhelmed when there are multiple patients who all need emergency care.

START (Simple Triage and Rapid Treatment)

The START system, developed by Hoag Hospital and the Newport Beach Fire Department (Newport Beach, CA), helps prepare emergency personnel to quickly organize their resources to handle multi-casualty emergencies. Using START, various agencies and individuals assume predetermined roles in managing the emergency, on-scene personnel quickly evaluate the situation and call in the appropriate extra resources and assign them specific tasks. Because of the planning and training that are the core of the START system, agencies and individuals know what they are expected to do when they arrive at the scene.

The triage portion of START, which is the focus of this training program, relies on making a rapid assessment (taking less than a minute) of every patient, determining which of four categories patients should be in, and visibly identifying the categories for rescuers who will treat the patients.

Triage
The concept of triage is simply a method of quickly identifying victims who have immediately life-threatening injuries AND who have the best chance of surviving so that when additional rescuers arrive on scene, they are directed first to those patients. 

Golden hour
The Golden hour refers to a concept that a trauma patient has the best chance for recovery if he or she can get to Advanced Trauma Life Support within one hour from the time of the injury. Obviously, those who are most seriously injured have the least time. When there are multiple victims, the Golden Hour can slip away because there aren’t enough rescuers for each victim.

START (Simple Triage and Rapid Treatment)
The START triage system, developed by Hoag Hospital and the Newport Beach Fire Department (Newport Beach, CA), relies on making a rapid assessment (taking less than a minute) of every patient, determining which of four categories patients should be in, and visibly identifying the categories for rescuers who will treat the patients.

_____ VIDEO _____
(Microsoft Windows Media Player needed.)
Click here to download.
[A rescuer moves through a bus crash scene,
assessing and categorizing the patients.
He spends less than a minute with each patient,
moving on as soon as he has determined the category.]

If you are the initial START rescuer, you DO NOT stop to do other than the most basic intervention. If you attempt to treat every patient before completing the triage,  you cannot assess the rest of the patients and identify the top priorities. 

Remember that in a serious disaster, it is unlikely that you can save all the victims. The important thing is to work together with the other rescuers to save as many patients as you can. START gives you the best chance of doing that.