START Triage

[Ledbelly]

My department is planning to go to the START triage system. I am curious to hear from others about their systems and/or their opinions about START or another system.
I am a 14 yr FF/EMT but a new medic(it's heck to be an Old rookie! http://www.firehouse.com/interactive/boards/smile.gif), and other than training, have no experience with either system. I don't know the 'name' of our current triage...primary survival scan w/red, yellow, yellow prime, etc... but have heard some express a dislike of START. Specifically, one of our guys recently watched a MCI drill at a neighboring dept. (using START) and he wasn't impressed; he felt that we had faster transport times and a better overall response with our current system. We are about to implement new protocols (including START) but there is still time to stop START. (sorry, had to say that) I would like to hear the good and bad if you use START or why you don't use it. Thanks in advance for the help....
Capn Lee

[BURNSEMS]

LedBelly, Our Dept Medical Protocl Requires the use of START during any MCI.We have only utilized it during drills but it seems to work fine,We to changed from the MET TAG System and had to adapt I.C. Principals to meet the START protocols, on average we can triage a patientin about 45 sec and then assighn a treatment and transport crew to the Patient, We to had reservations about the change but we like the ease of the Triage procedure, We had to overcome the Urge to Fix problems on the Spot and move from patient to patient in a orderly fashion
but as we practice it becomes a little better every time.

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Here today for a Safer Tomorrow

[Drew Smith]

We use START. We used to use a system with "yellow prime" and I never quite like the logic that went with it. I think START is great. I have been trying to get our medics to use it on every MVA with more than two patients and here is why: Just like ICS, if you do not use it regularly you will never master it. Where START usually causes a problem for people is that START is not the final triage, it is the starting point. START is designed to get a handle on the situation. START is not perfect and neither are the responders.

I routinely use START as an officer. I use it to determine who is seen first by EMS and to determine how many ambulances to call for. This forum does not allow for me to elaborate further.

[FFLEEMS]

My department has only had the training in START, but I like it, it is a much better system. It is a very logical approach to MCIs, but you do have to train on it. The good thing about it is you don't have to have indepth medical training to use it. It can be done by a first responder, freeing up your EMTs and medics for treatment. I think you should give it a try, there is no real expense involved and if you don't like it, it is easy to change back.

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[phyrngn]

Our department uses START or a bastardization of it's form...RPM. RPM stands for Respirations, Pulse, Mental Status. The basic idea is that as a person assigned to TRIAGE someone, you are NOT TO TREAT the patient...just assess if they are alive and breathing. First, you check their airway...if they are breathing, note the quality...agonal respirations, etc...if they are not breathing, they are dead. Then check a quick carotid...again, no pulse, dead...Mental Status...basically, if they can get up and move, they are green, if they can respond to you but can't get up, they are yellow, and so on...after the RPM is done, then a Secondary Triage takes place, and they are sorted again. The main thing that really makes or breaks a triage system, is that you practice it on every call. Even if you have two patients in a minor rear-end collision, you still have a call that Incident Command will require you to set up Treatment and Transport priorities. This is done through Triage...

Practice, practice, practice on the little ones, and get ready for the big ones!!

Good luck!

[Phred]

?

Is there a web site that documents the procedures involved in the START system?

[Ledbelly]

Hey I don't know Phred...but if you find one let me know. It sounded like we were going to change in Aug...but haven't heard another word, even tho protocols are out. Course I just got my new mask/SCBA yesterday that we were supposed to get in Feb...

[Phred]

Found a site that has an outline of steps for performing the START Triage System: check out
www.fl5dmat.com/DrLou/start.htm (http://www.fl5dmat.com/DrLou/start.htm) .

Has anyone else found any other START sites?

[Ledbelly]

Phred...that's great! Thanks for the help. We still haven't heard another word about it.... Bookmarked the site tho'. I haven't had time to look for anything, if I do find something else I'll holler.
Lee

[fireemt03]

START works and is a really good system i sugest you use it.
Good luck.

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Corey J. Molinelli NREMT
Asst. Fire Chief

[billy]

Hi Folks,
I've taught the START system severl times to various organizations. It seems to work well for initial triage, as previously noted in the posts.

If anyone is interested, I have the complete training package. Please email.

Thanks.

[Romania]

We just started using the START system in Arizona in the past few years. Phoenix Fire developed a traige fanny pack and tag that is avalible through boundtree/ALS that is great. So far the system seems to be doing very well and is simple enough. The only draw back is that most medics are used to working patients that would be traiged "black - dead/dying". But, that happens with all traige systems. THis system takes some getting used to, but it does work well and provides the best care for the most patients at an MCI.

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Alan Romania, CEP

[Ledbelly]

Just wanted to thank all for the input and information. I hope I didn't come across as absolutely against the START system; while trying to keep an open mind, the only previous reference I had was the one person who wasn't impressed with it. From the sound of many of your posts, I am anxious to give it a go.

Thanks again, Lee