What is START Triage?

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Today, let’s learn four important viewpoints about START (Simple Triage and Rapid Treatment).


What is START Triage?

START is a method used by first responders to effectively and efficiently evaluate all of the victims during a mass casualty incident.

Important four viewpoints are Walking, Respiration, Pulse and Mental Status.

To put it simply,

  • He can walk → Minor care(walking wounded) / Green
  • Vital signs are normal. → Delayed urgent care / Yellow
  • Any of the vital signs are abnormal. → Immediate care(life threatening) / Red
  • He is Not breathing. → Dead / Black

Then, let’s learn the details about the above viewpoints.



This is the biggest feature of Green label.

He can walk by himself.

If he needs any hands to walk, you can’t tag him with a Green label.

When you say “Come here! ”, they who will be tagged with Green labels can walk to you.

However, Green labels victims are Not always perfect, any of them are critically injured. So, we always need to pay attention to them.

Well, the most part of victims are tagged with Green labels!


We should check the respiration, the most important viewpoint of ABCDE Approach.

First, we check “Is the victim breathing Naturally?”.

If he isn’t, we will try to clear the airway and perform any airway methods to get the victim breathing. We make the airway and look, feel and listen his breathing.

If all attempts are failure, he is probability dead; Black label.

Next, we check the respiration rate.

Adult’s respiration rate is 10-29 / min. So, both less 10 and more 29 /min are tagged with a Red label.


The original START says we do the Blanch Test (capillary refill), but today we learn to check the radial pulse as an easier technique.

If the victim’s radial pulse is absent, and thus he is tagged with a Red label.

And more than 120 / min pulse (tachycardia) is so danger, he is done with a Red label.

Mental Status

We ask the victim to follow simple commanders, for example “Tell me your name.”, “Hold on my hand.” ,and so on.

If he is successful, he is tagged with a Yellow label. In addition, he can’t do something but he says “No!” or “What?”, he is tagged with Yellow.

The victim can follow or react and thus he is tagged with a Yellow label. And he cannot, he is done with a Red label.

The above are the four important viewpoints of START. Do you understand the way of START? The flow chart is shown below. This is so famous, and you should master!!!

START Triage algorithm