Mass Casualty Triage
Mass Casualty Triage is included in this California-based EMT program reflecting its utility for EMTs in the field. It is not required for National NREMT registration or skills verification for California Registration.
First responders using START evaluate victims and assign them to one of the following four categories:
- Deceased/expectant (black)
- Immediate (red)
- Delayed (yellow)
- Walking wounded/minor (green)
The colors correspond to triage tags, which are used by some agencies to indicate each victim's status, although physical tags are not necessary if patients can be physically sorted into different areas.
Responders arriving to the scene of a mass casualty incident may first ask that any victim who is able to walk relocate to a certain area, thereby identifying the ambulatory, or walking wounded, patients. Non-ambulatory patients are then assessed. The only medical intervention used prior to declaring a patient deceased is an attempt to open the airway. Any patient who is not breathing after this attempt is classified as deceased and given a black tag. No further interventions or therapies are attempted on deceased patients until all other patients have been treated. Patients who are breathing and have any of the following conditions are classified as immediate:
- Respiratory rate greater than 30 per minute;
- Radial pulse is absent, or capillary refill is over 2 seconds;
- Unable to follow simple commands
All other patients are classified as delayed.