2. S.T.A.R.T. Triage S.T.A.R.T. Logo and Algorithm reprinted with permission of Hoag Memorial Hospital Presbyterian and Newport Beach Fire Department.

3. Course Objectives Define MCI Describe Levels of On-scene Triage for MCI Describe the Use and Purpose of START Triage as an Initial Triage System Describe the Accepted Use of START Triage Tags

4. MCI Multi Casualty Incident An accident or emergency that overwhelms local response capability

5. ICS Creates and provides for compatibility and integration of all responding agencies

6. ICS Incident Command System Structural approach to emergency response –Personal Roles –Lines of Authority –Effective Communication

7. MCI? Multi Casualty Incident Mass Casualty Incident MVI Multi or Mass Victim Incident

8. Field Triage Accomplish the greatest medical good for the greatest number of people

9. Effective Field Triage Medically responsible Rapid Simple Smooth Transitions

10. Field Triage Consortium Medical Command TriageTreatmentTransport Primary Triage Tertiary Triage Secondary Triage

11. Speed Accuracy Organization

12. 3 Assessments Ventilation Perfusion Cognition 2 Treatments Airway Maintenance Hemorrhage Control

15. RESPIRATION NONEYES REPOSITION AIRWAY ASSESS RESPIRATIONS/VENTILATION NONE DECEASED YES IMMEDIATE < 30/MINUTE ASSESS PERFUSION > 30/MINUTE IMMEDIATE PERFUSION < 2 SECONDS ASSESS MENTAL STATUS > 2 SECONDS CONTROL BLEEDING IMMEDIATEED MENTAL STATUS FOLLOWS SIMPLE COMMANDS DELAYED FAILS TO FOLLOW SIMPLE COMMANDS IMMEDIATE

16. RESPIRATIONS/VENTILATION NONEYES REPOSITION AIRWAY ASSESS RESPIRATIONS/VENTILIATION NONE DECEASED YES IMMEDIATE < 30/MINUTE ASSESS PERFUSION > 30/MINUTE IMMEDIATE

17. PERFUSION < 2 SECONDS ASSESS MENTAL STATUS > 2 SECINDS CONTROL BLEEDING IMMEDIATE

18. MENTAL STATUS FOLLOWS SIMPLE COMMANDS FAILS TO FOLLOW SIMPLE COMMANDS DELAYED IMMEDIATE

19. START WHERE YOU STAND

20. Walking Wounded

21. Primary Triage Rapid patient assessment and tagging Immediate live sustaining care, as necessary

22. Secondary Triage Document, reassess and sort patients by treatment needs Provide medical treatment as appropriate and available

23. Tertiary Triage Reassess condition of patients relevant to resources, transportation and medical facilities Determine priority for disposition of patients from incident site

24. Normal Pediatric Vital Signs

25. Exercise Objectives Rapid and accurate application of START Triage during an MCI