EMS Incident Management - JumpSTART Triage System

The JumpSTART triage system is a method used by EMS Providers to assess and prioritize pediatric patients in a mass casualty incident. The system was developed at the Miami, Florida Children's Hospital in 1995 by Dr. Lou Romig.

Here's what EMS Providers need to know about the JumpSTART triage system:

1. Focus on Pediatric Patients: JumpSTART is specifically designed for triaging infants and children (typically aged 1 to 8 years) during mass casualty incidents. It takes into account the unique physiological and anatomical characteristics of pediatric patients.

2. Triage Categories: The JumpSTART triage system uses four triage categories:

- Green: Walking Wounded. Patients who can walk and have minor injuries. Lowest priority.

- Yellow: Delayed. Patients who require medical attention but are not in immediate danger. Middle priority

- Red: Immediate. Patients with life-threatening injuries who require immediate intervention. Highest priority.

- Black: Deceased or Expectant. Patients who are deceased or have injuries incompatible with survival. Lacking priority

3. START Assessment: JumpSTART utilizes a simplified version of the START (Simple Triage and Rapid Treatment) assessment for pediatric patients. EMS providers quickly evaluate each patient's respiratory status, perfusion, and mental status to assign a triage category.

4. Focused on Breathing: JumpSTART places significant emphasis on respiratory status. Children who can walk, follow commands, and have a respiratory rate of less than 45 breaths per minute are classified as green. Those with respiratory rates above 45, altered mental status, or poor perfusion are assigned higher triage categories.

5. Age-Appropriate Assessments: The JumpSTART system recognizes that different age groups may exhibit varying physiological responses. EMS providers use age-appropriate methods to evaluate respiratory status, such as observing chest rise, auscultating breath sounds, or assessing the patient's ability to speak.

6. Ongoing Reassessment: Like other triage systems, JumpSTART emphasizes the importance of ongoing reassessment. Patients initially classified as green or yellow may deteriorate, requiring a change in the triage category as their condition evolves.

Remember, that specific protocols and guidelines may vary between different EMS systems and regions.

It's crucial for EMS providers to receive training and familiarize themselves with the triage system implemented in their area to effectively respond to mass casualty incidents involving pediatric patients.

EMS Mnemonics - TICLS

The TICLS mnemonic is a useful tool for EMS providers during pediatric patient assessments.

Here's what you should know:

T - Tone: Assess the child's muscle tone. Are they floppy or rigid?

I - Interactiveness: Observe their level of interaction. Are they responsive or unresponsive?

C - Consolability: Determine if the child can be consoled or comforted.

L - Look or Gaze: Assess their eye contact and gaze. Are they making appropriate eye contact?

S - Speech or Cry: Evaluate the quality of speech or cry. Is it appropriate for their age?

Using the TICLS approach helps providers quickly assess the child's neurological status and identify any abnormalities or concerns.

It's important to remember that this is just one component of a comprehensive pediatric assessment, and additional assessments and interventions may be necessary based on the specific situation.