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	Triage Guidelines Overview "START" Algorithm (Simple Triage and Rapid Treatment) for Mass Casualty Events Radiation Algorithms Triage Categories with and without Combined Injury Overview Life threatening problems should be addressed before treatment for exposure or contamination, with consideration for the safety of the first responders. In mass casualty settings consider using "START" algorithm for adults "JumpSTART" algorithm for children REMM provides algorithms for radiation treatment Contamination Exposure Exposure + Contamination Sample of Triage Tag for Radiation Incident (PDF - 127 KB) Additional Reference: Smith JM, Ansari A, Harper FT. Hospital management of mass radiological casualties: reassessing exposures from contaminated victims of an exploded radiological dispersal device. Health Phys. 2005 Nov;89(5):513-20. [PubMed Citation] top of page "START" Algorithms for Mass Casualty Events "START" Algorithm (Adults) JumpSTART Algorithm (Children) top of page Radiation Algorithms REMM provides algorithms for radiation triage Contamination Exposure Exposure + Contamination Other radiation triage algorithms: Thoma GE, Wald N. The diagnosis and management of accidental radiation injury. J Occup Med 1959;1:421-47. Kuniak M, Azizova T, Day R, Wald N, Suyama J, Zhang A, Sumina MV, Pesternikova VS, Vasilenko E, Soaita A, Slaughter DM. The Radiation Injury Severity Classification (RISC) system: an early injury assessment tool for the frontline health-care provider. Br J Radiol. 2008 Jan 7; [Epub ahead of print] [PubMed Citation] Armed Forces Radiobiology Research Institute (AFRRI) - Biodosimetry Assessment Tool (BAT) Fliedner TM, Frieseche I, Beyrer K, editors. Medical management of radiation accidents: manual on the acute radiation syndrome. Oxford, UK: British Institute of Radiology, 2001. top of page Triage Categories with and without Combined Injury Priorities in Triage of Patients with and without Combined Injury Based on Dose of Radiation (in units of gray) (What is gray (Gy)?) Modified Military Triage System Used in Mass Casualty Scenarios D Adapted from: Waselenko JK, MacVittie TJ, Blakely WF, Pesik N, Wiley AL, Dickerson WE, Tsu H, Confer DL, Coleman CN, Seed T, Lowry P, Armitage JO, Dainiak N; Strategic National Stockpile Radiation Working Group. Medical management of the acute radiation syndrome: recommendations of the Strategic National Stockpile Radiation Working Group. Annals of Internal Medicine 2004; Vol. 140:1037-51. [PubMed Citation] Walker RI, Cerveny RJ, eds. Medical Consequences of Nuclear Warfare. Falls Church, VA: Office of the Surgeon General; 1989 (PDF - 414 KB) (AFRRI) top of page   References Benson M, Koenig KL, Schultz CH. Disaster triage: START, then SAVE-a new method of dynamic triage for victims of a catastrophic earthquake. Prehospital Disaster Med. 1996; Apr-Jun; 11(2): 117-24 [PubMed Citation] START Support Services (Newport Beach, CA Fire Department, Commercial site, no endorsement implied) Alternative version of START algorithm (Critical Illness & Trauma Foundation, Inc., 2001) Cone DC, Koenig KL. Mass casualty triage in the chemical, biological, radiological, or nuclear environment. Eur J Emerg Med 2005; 12:287-302 [PubMed Citation] Garner A, Lee A, Harrison K, Schultz CH. Comparative analysis of multiple-casualty incident triage algorithms. Annals of Emergency Medicine [PubMed Citation] Sacco WJ, Navin DM, Fiedler KE, et al. Precise Formulation and Evidence-based application of resource-constrained triage. Acad Emerg Med 2005, 12(8):759-770 [PubMed Citation] Cone DC, MacMillan DS. Mass-casualty triage systems: A hint of Science. Acad Emerg Med 2005, 12(8): 739-741 [PubMed Citation]

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