What triage system is used for mass casualty incidents to rapidly categorize patients?

• A. START (Simple Triage and Rapid Treatment) method
• B. SALT (Sort, Assess, Lifesaving Interventions, Treatment)
• C. ABCDE triage
• D. MASCAL triage

Answer: (A)

Triage in mass casualty incidents is all about making fast, life-saving decisions with minimal steps. START does exactly that by using a simple, repeatable sequence to sort people quickly into priority categories so limited resources go where they’re most needed.

The approach starts by seeing who can walk. If a person can walk to safety, they’re assigned as minor, since they’re able to reach help on their own. For those who can’t walk, you move to a few rapid checks: first, breathing. If the patient isn’t breathing after you open the airway, they’re categorized as not rescuable with basic field effort unless immediate intervention is evident, which effectively places them in the highest-priority group for life-saving care. If the person is breathing, you then look at the rate—if the breaths are very fast (roughly more than 30 per minute), that signals significant distress and assigns high priority. If the breathing rate is in a normal range, you assess circulation by checking the pulse or capillary refill. Poor perfusion means immediate attention is needed. If circulation seems adequate, you check whether the person can follow simple commands to gauge mental status; inability to follow commands moves them into the immediate category, while the ability to follow commands places them in a delayed or minor category.

This flow creates four quick categories: immediate, delayed, minor, and deceased, enabling responders to focus life-saving interventions on those most likely to benefit first. START is designed for speed and simplicity, which is why it’s the commonly taught method for rapid field triage. Other systems exist, but they either involve more steps, target different scenarios, or aren’t as optimized for ultra-rapid field categorization.