9/15/2016

STARTAdultTriageAlgorithmCHEMM

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STARTAdultTriageAlgorithm
STARTadulttriagealgorithmIllustration
Backgroundinformation

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STARTAdultTriageAlgorithmCHEMM

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Backgroundinformation
STARTwasdevelopedbytheNewportBeachFireandMarineDepartmentandHoagHospitalinNewportBeach,Californiain
1983. 2
Initiallyitusedtheabilitytoobeycommands,respiratoryrate,andcapillaryrefilltoassigntriagecategory.
ModificationstoSTARTin1996byBensonet.al.substitutedradialpulseforcapillaryrefill,withareportofimproved
accuracy,especiallyincoldtemperature. 1
TheBensonrevision(STARTSAVE[SecondaryAssessmentofVictimEndpoint]),alsoincorporatesadditionalfactorsthat
determine"survivability"overtimeastheeventprogressesandassumeslimitedresponseresources. 1

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STARTAdultTriageAlgorithmCHEMM
Therehasbeenlimitedrigorousscientificreviewofvariousformsofmasscasualtyincidenttriageusedaroundtheworld. 1,4
6

Newmethodsoftriageusingnewalgorithmshavebeenproposed,butnottestedinthefield 5,6
AtpresentSTARTremainsthemostcommonlyusedmasscasualtytriagealgorithmintheUS.
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References
1.BensonM,KoenigKL,SchultzCH.Disastertriage:START,thenSAVEanewmethodofdynamictriageforvictimsofa
catastrophicearthquake.PrehospitalDisasterMed.1996AprJun11(2):11724[PubMedCitation]
2.STARTSupportServices(NewportBeach,CAFireDepartment,Commercialsite,noendorsementimplied)
3.AlternativeversionofSTARTalgorithm(CriticalIllness&TraumaFoundation,Inc.,2001)
4.GarnerA,LeeA,HarrisonK,SchultzCH.Comparativeanalysisofmultiplecasualtyincidenttriagealgorithms.AnnEmerg
Med,200138:541548.[PubMedCitation]
5.JenkinsJL,McCarthyML,SauerLM,etal.Masscasualtytriage:timeforanevidencebasedapproach.PrehospDisasterMed,
200823:38[PubMedCitation]
6.ConeDC,KoenigKL.Masscasualtytriageinthechemical,biological,radiological,ornuclearenvironment.EurJEmergMed
200512:287302[PubMedCitation]
7.SaccoWJ,NavinDM,FiedlerKE,etal.PreciseFormulationandEvidencebasedapplicationofresourceconstrainedtriage.
AcadEmergMed2005,12(8):759770[PubMedCitation]
8.ConeDC,MacMillanDS.Masscasualtytriagesystems:AhintofScience.AcadEmergMed2005,12(8):739741[PubMed
Citation]
9.LernerEB,SchwartzRB,CoulePL,etal.,Masscasualtytriage:Anevaluationofthedataanddevelopmentofaproposed
nationalguideline.DisasterMedandPublicHealthPreparedness,20082(Suppl1):S25S34.[PubMedCitation]
10.SALTMassCasualtytriage:conceptendorsedbytheAmericanCollegeofEmergencyPhysicians,AmericanCollegeof
SurgeonsCommitteeonTrauma,AmericanTraumaSociety,NationalAssociationofEMSPhysicians,NationalDisasterLife
SupportEducationConsortium,andStateandTerritorialInjuryPreventionDirectorsAssociation.DisasterMedandPublic
HealthPreparedness,20082(4)245246.[PubMedCitation]

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Lastupdated:FriOct312014

U.S.DepartmentofHealth&HumanServices,
OfficeoftheAssistantSecretaryforPreparednessandResponse,NationalLibraryofMedicine

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