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Mass Casualty Triage: START and SALT Systems

Rapid triage protocols are applied to maximise survival with limited resources during mass-casualty incidents.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Mass Casualty Triage: START and SALT Systems?

Mass casualty triage is a systematic approach for prioritising care when the number of casualties exceeds available resources. START is used in adults and JumpSTART in children.

SALT (Sort-Assess-Lifesaving interventions-Treatment/Transport) is a newer American consensus model that allows minimal lifesaving interventions during sorting.

Colour-coded labelling (red, yellow, green, black) categorises urgency, and patients are evacuated accordingly.

Symptoms

Walking wounded (green)
Urgent but stable casualties (yellow)
Life-threatening but salvageable (red)
Expected mortality with limited resources (black)
Patient with patent airway but no spontaneous breathing
Capillary refill >2 seconds
Confused patient
Severe haemorrhage

Risk Factors

Lack of trained personnel
Scene safety problems
Risk of secondary explosion or chemical exposure
Communication breakdown
Mismatch between resources and casualty volume
Invalid labelling
Premature intensive intervention on individual patients

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Code yellow/red is activated upon mass casualty notification
  • Triage area is established near the evacuation route
  • Each patient is reassessed every 30 seconds
  • Black tag decision is left to the most experienced team leader

Treatment Methods

01
Assess scene safety and incident size
02
In START, separate walking wounded (green)
03
Open the airway if there is no breathing
04
Tag red for breathing >30/min, capillary refill >2 sec or failure to follow commands
05
Tag yellow for stable but non-ambulatory patients
06
Apply minimal lifesaving interventions (airway, haemorrhage control, needle thoracostomy)
07
Attach colour-coded tag
08
Evacuate red tags first
09
Coordinate with hospital disaster plan
10
Conduct post-incident debriefing and documentation

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.