Which triage system is commonly used to do the greatest good for the greatest number in the shortest time?

• A. START (Simple Triage and Rapid Treatment)
• B. SALT
• C. ABC
• D. DEPART

Answer: (A)

In mass-casualty situations, the goal is to do the greatest good for the greatest number in the shortest time, so triage uses a quick, standardized method to sort patients by who needs immediate life-saving care and who can wait. The system that best fits this aim is Simple Triage and Rapid Treatment. It uses a fast, few-step assessment for every patient: determine if they are breathing after opening the airway; if not, they’re prioritized for quick intervention or marked as deceased if there’s no breathing after airway opening. If they are breathing, check the respiratory rate—if it’s very high (over about 30 per minute), they’re tagged as immediate. If the rate is acceptable, assess perfusion by feeling for a pulse or checking capillary refill; poor perfusion means red priority. If perfusion is adequate, test mental status by asking the patient to follow simple commands; inability to follow commands flags red. If the patient can follow commands, they’re moved toward yellow (delayed) or green (minor) depending on other injuries. This rapid color-coded sorting lets responders quickly identify who needs lifesaving help now and who can wait, maximizing survivors given limited resources. Other systems exist, but START is the traditional, widely taught method for achieving that rapid, broad sorting in chaotic scenes.