A Better START for Low-Acuity Victims Data-driven Refinement of Mass Casualty Triage

The authors used data from 322,162 subjects in the National Trauma Database (NTDB) to assess gaps of the START algorithm when it is used to triage low-acuity patients. They identified factors for mistriage of “Green/Minor” level patients who died in the hospital (N=2,046), and then developed and tested evidenced-based improvements to START using an iterative process. They concluded that START accuracy was significantly improved when elderly, but otherwise minimally injured patients were triaged as “Yellow” instead of “Green.”