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
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?
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
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