JumpSTART: Triaging Children in

Multicasualty Incidents

Lou E. Romig MD, FAAP, FACEP

Miami Children’s Hospital

Miami-Dade Fire Rescue

FL-5 DMAT

Why MCI triage?

A rapid assessment of medical needs of victims with the goal of prioritizing care based on those needs

Based on the assumption that human resources, equipment and supplies are initially limited and strained

Current MCI triage tools address only primary triage

Secondary and tertiary triage are more complex and demand more sophisticated resources

Why MCI triage?

A system tool to help draw organization out of chaos

Helps to get resources to the patients who will benefit from them the most

Improves efficiency and effectiveness of medical prioritization and helps smooth patient flow through the medical system

Objective triage tools insulate responders from the emotional burden of making life or death decisions

Why a pediatric tool?

Daily Emergencies

Do the best for each individual.

Disaster SettingsDo the greatest good for

the greatest number. Maximize survival.

Why a pediatric tool?

Children have key physiologic differences that are not recognized by adult-based triage tools.

Tools based on adult physiology, such as START, can result in both under- and over-triage of some children.

Objective pediatric triage guidelines can benefit all MCI victims, the triaging responders, and the overall flow of victims from the disaster scene.

Why JumpSTART?

Why JumpSTART?

The first pediatric-specific objective MCI triage tool in the US (and the world?)

Suitable for use with special needs children and potentially for WMD primary triage

Rapidly approaching gold standard status in the US and Canada

Adopted with START as the triage tools of choice for the Florida disaster plan

Taught internationally in at least eight countries

Information distributed at no charge via website at www.jumpstarttriage.com

Who could use JumpSTART?

EMS volunteers and professionals

Other first responders, including CERT personnel

ED staff

School nurses and other school staff

Staff members of any organization where children gather in large groups

What does it take to use JumpSTART?

2-4 hours of didactic and exercise time, using materials available at no charge from the JumpSTART website

Periodic refresher training

Colored tagging materials (contractors’ tape or triage tags)

Pocket reference card

Barrier device for ventilation of children with a pulse but no breathing

Personal protective equipment

ConclusionThe ability to triage victims of all ages is an important aspect of disaster preparedness

JumpSTART: is an appropriate tool for primary pediatric MCI triage in a number of settings

parallels START, the most widely used adult triage tool (the KISS principle!)

is already acknowledged in the Florida disaster plan

is easy and inexpensive to implement

Questions?