ATLS Triage and Mass Casualty Incidents 1 — Questions and Answers
Question 1: In the START triage system, what is the first assessment step performed?
- Instruct all ambulatory patients to move to a designated area, tagging them as Minor (Green) (Correct answer)
- Check respiratory rate of all patients first
- Assess mental status of all patients first
- Control all bleeding before categorizing patients
Correct answer: Instruct all ambulatory patients to move to a designated area, tagging them as Minor (Green)
The first step in START triage is to call out for ambulatory patients to walk to a designated area, immediately categorizing them as Minor (Green) and clearing the scene for more critical assessment.
Question 2: In START triage, a patient has absent respirations. You reposition the airway and respirations resume at 22 breaths per minute. What color tag is assigned?
- Red (Immediate) (Correct answer)
- Black (Expectant/Deceased)
- Yellow (Delayed)
- Green (Minor)
Correct answer: Red (Immediate)
When respirations return after simple airway repositioning, the patient is tagged Red (Immediate) because they require a basic airway maneuver to survive.
Question 3: Under the START triage system, which respiratory rate threshold triggers a Red (Immediate) tag without further assessment?
- Greater than 30 breaths per minute (Correct answer)
- Greater than 20 breaths per minute
- Less than 12 breaths per minute
- Any respiratory rate above 24
Correct answer: Greater than 30 breaths per minute
In START triage, a respiratory rate greater than 30/min indicates physiologic compromise and automatically assigns a Red (Immediate) tag.
Question 4: During a mass casualty incident (MCI), a Black tag is assigned to which category of patient?
- Patients who are deceased or have injuries incompatible with survival given available resources (Correct answer)
- All patients who are unconscious
- Patients with severe head injuries only
- Patients in cardiac arrest who received CPR
Correct answer: Patients who are deceased or have injuries incompatible with survival given available resources
Black tagging in MCI triage identifies patients who are dead or whose injuries are so severe that survival is unlikely even with maximal intervention, preserving resources for salvageable patients.
Question 5: In a mass casualty event, which principle best describes the goal of triage?
- Do the greatest good for the greatest number of patients (Correct answer)
- Treat the most severely injured first regardless of survival probability
- Treat patients in order of arrival
- Stabilize all patients before transport
Correct answer: Do the greatest good for the greatest number of patients
MCI triage follows utilitarian principles: allocating limited resources to maximize the number of survivors, which may mean bypassing the most critically injured if survival odds are minimal.
Question 6: JumpSTART triage differs from START in that it is specifically designed for which patient population?
- Pediatric patients under 8 years old or less than 45 kg (Correct answer)
- Geriatric patients over 65
- Burn patients
- Penetrating trauma victims
Correct answer: Pediatric patients under 8 years old or less than 45 kg
JumpSTART adapts START criteria for pediatric physiology, incorporating 5 rescue breaths for apneic children before assigning a Black tag, recognizing children's better response to airway management.
ATLS Triage and Mass Casualty Incidents 1
In the START triage system, what is the first assessment step performed?