In START, what sequence is used in the 1 minute guideline?

• A. Airway, Breathing, Circulation
• B. Consciousness, Mobility, Temperature
• C. Respirations, Perfusion, Mental Status
• D. Blood pressure, Heart rate, Oxygen saturation

Answer: (C)

In START triage the rapid 1-minute screen uses the RPM sequence: Respirations, Perfusion, Mental Status. Start by judging breathing after opening the airway: if the person isn’t breathing, they’re prioritized immediately (in most mass-casualty protocols this means the highest priority or nonviable in that moment). If they are breathing, quickly assess the respirations to gauge threat level. Next, check perfusion by feeling for a pulse or looking at capillary refill to see whether blood flow is adequate. Poor perfusion marks the patient as high priority. If perfusion is adequate, assess mental status by asking the person to follow simple commands to determine their level of responsiveness. Those who can walk to safety are considered minor. So the order—Respirations, Perfusion, Mental Status—is what the 1-minute START guideline follows.