A critical review of the START and Jump START triage protocols in emergencies and disasters: challenges and suggestions

Articles in Press

Document Type : Letter to Editor

Authors

1 Assistant Professor, Department of Health in Disasters and Emergencies, Shiraz University of Medical Sciences, Shiraz, Iran

2 shiraz university of medical sciences

3 Department of Medical Emergencies, School of Paramedicine, Faculty of Jahrom University of Medical Sciences, Jahrom, Iran.

10.30476/jhmi.2024.102751.1222

Abstract

In the START triage, a red tag is assigned to the respiratory rate of more than 30/minute in the first moment. However, many non-acute factors, including emotional and psychological reactions, can cause this labeling. This problem will have two undesirable consequences. First, the majority of the injured have psychological and physiological reactions in most incidents and disasters. The physiological response may include tachycardia, tachypnea, and other hemodynamic changes. Therefore, these physiological reactions may cause over-triage. Second, if the patient is triaged based on the respiratory rate of more than 30/minute, it will cause the mental reactions to be falsely prioritized for treatment and transfer at the accident scene, while service delivery to other critically ill patients will be delayed. Another issue is that the respiratory rate may be less than 30/ minute (normal range), but the breathing volume is insufficient; in this case, the patient will suffer from hypoxemia and should receive a red label.

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Health Management & Information Science

Articles in Press, Accepted Manuscript
Available Online from 09 October 2024

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