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You are here: Home > START Adult Triage Algorithm > Text Version


START Adult Triage Algorithm: Text Version

  • 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
  • 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.
  • 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.
  • The 4 Triage Categories are:
    • 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"
    • 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
    • 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)
    • 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

US Department of Health & Human Services     
U.S. Department of Health & Human Services Office of the Assistant Secretary for Preparedness and Response National Library of Medicine