Accuracy of the Simple Triage and Rapid Treatment (START) algorithm in accident and disaster triage: an integrative review
DOI:
https://doi.org/10.33448/rsd-v11i15.37234Keywords:
Mass Casualty Incidents; Protocol; Triage.Abstract
The Simple Triage and Rapid Treatment (START) algorithm was proposed to identify salvageable victims from those with imminent mortality, and is the most popular triage system worldwide. Therefore, demonstrating the accuracy of the START protocol is of fundamental importance, since it operates in an extreme scenario and time and effective decision making can save lives. Thus, this study aims to analyze the accuracy of the START algorithm in triage of accidents and disasters. This is an integrative literature review, and the following databases were used for the research: PUBMED, LILACS, and COCHRANE. The screening process had the following inclusion criteria: articles that answered the guiding question, in English or Portuguese, and between 2017 and 2021. After the searches, a total of 7 articles were obtained for review. Victim management using the START protocol allows the rescuer to quickly decide the expected level of care needed in order to focus advanced pre-hospital care on patients requiring immediate interventions. This algorithm could significantly hasten the triage process and reduce under-triage over time, even when adopted by non-medical personnel, especially when establishing triage points. Correct triage was demonstrated in 36% of patients, with under-screening occurring in 56.8% of patients. Overall, the START protocol meets the needs of mass casualty care, but it needs modifications to become a more effective protocol. Thus, it is necessary to continue with new studies on the accuracy and ways to optimize this protocol in order to optimize the triage system, promoting quick and effective decision making.
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