START Adult MCI Triage
START adult mass-casualty triage: sorts to Minor (green), Delayed (yellow), Immediate (red), or Expectant (black) from ability to walk, breathing, respiratory rate, perfusion, and ability to follow commands.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Patient can walk
- Yes
Result: Minor (green): patient can walk.
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Patient can walk
- Patient is breathing (before any maneuver)
- Breaths return after airway repositioning?
- Respiratory rate
- Radial pulse present and cap refill < 2 s
- Follows simple commands
What this is
Walk a single adult patient through the START (Simple Triage and Rapid Treatment) algorithm and return a triage category - GREEN (walking wounded / minor), YELLOW (delayed), RED (immediate), or BLACK (deceased / expectant). START asks the four canonical bedside questions in order: can the patient walk, is breathing present after a single airway opening, what is the respiratory rate, what is the radial pulse / capillary refill, and can the patient follow simple commands. Sophie Well asks the same questions in the same order and shows the category plus the rationale.
When to use it
Use this in a mass-casualty incident (MCI), an active-shooter triage exercise, or a tabletop drill where adult patients need to be sorted in under 60 seconds each. START is the U.S. civilian default and is what FEMA, the National EMS Scope of Practice Model, and most state EMS protocols teach; in a real MCI the on-scene incident commander chooses the protocol. For pediatric patients (roughly age 1-8) use the JumpSTART tool instead - it accounts for the higher pediatric respiratory rate baseline and the rescue-breath rule that distinguishes pediatric apnea from adult apnea.
How this is calculated
Super G, et al. START: Simple Triage and Rapid Treatment. Newport Beach Fire Department / Hoag Hospital, 1983. Public-domain MCI triage protocol.
Source: START / JumpSTART algorithm reference
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.
More in Triage and acuity.