JumpSTART Triage (Pediatric)

The primary goal of this question is to separate patients that can walk (“walking wounded”) from those who cannot. Patients that can walk are likely not at risk of immediate death. Do not force any patients to walk. Have ambulatory patients walk to a designated area, clearing space for responders to access more critical patients.

This question is primarily used to separate those who are already deceased from those who are not. During a mass-casualty incident, there are typically insufficient resources to resuscitate a critical patient.

Position the airway using the head-tilt/chin-lift method or jaw-thrust maneuver. With positioning, you are opening the airway by preventing the tongue from obstructing the airway. After positioning, assess whether the patient has spontaneous respirations.

If a patient is not breathing, assess for a pulse. In pediatric patients, respiratory failure often precedes cardiac arrest; therefore, apneic pediatric patients with a pulse have a greater chance of survival.

If a patient has a pulse but does not have spontaneous respirations, 5 rescue breaths are provided in an attempt to stimulate spontaneous breathing.

A slow (<15) or rapid (>45) respiratory rate can be an indicator of poor perfusion or respiratory compromise.

Assess for the presence of a peripheral pulse. An absent peripheral pulse may be an indicator of poor perfusion, often caused by blood loss.

Assess mental status using the AVPU scale. AVPU is an acronym for alert (patients who are awake), verbal (patient responds only to verbal stimuli), pain (patient responds only to painful stimuli), or unresponsive (patient does not respond to any stimuli). Appropriate responses to painful stimuli are purposeful movements, such as localizing or withdrawing from pain.