Mass Casualty & Triage
MCIs test your ability to shift from best patient care to greatest good for the greatest number. Triage sorts, IC organizes, and transport moves patients — in that order.
EMT · AEMT · Paramedic
START adult triage
Walking wounded → GREEN. Then assess RPM: Respirations, Perfusion, Mental status.
- No respirations after airway repositioned → BLACK
- Respirations > 30 → RED
- Cap refill > 2 sec OR no radial pulse → RED
- Fails to follow simple commands → RED
- Otherwise → YELLOW
JumpSTART for pediatrics
The peds twist: if apneic after airway opening, check pulse. If pulse present, give 5 rescue breaths — if breathing returns → RED. If still apneic → BLACK. Kids get one more chance because primary respiratory arrest is common.
Incident command basics
First arriving unit establishes command and gives a scene size-up. Set up staging, triage, treatment, and transport sectors. Do not commit to patient care until command structure is set — one paramedic buried in a patient means no one is running the scene.
Transport priorities
Reds transport first, closest appropriate facility. Yellows and greens distribute across region to avoid overwhelming a single ED. Blacks stay on scene for later handling and reassessment as resources become available.
Frequently asked
- What's the maximum time you spend on any one MCI patient during triage?
- About 30 seconds. Reposition airway, check RPM, tag, move on.
- Can I retriage a BLACK tag?
- Yes. Triage is dynamic. If resources become available and the patient still has a pulse, retriage upward and treat.
Test yourself
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