In the START system, which tag should be evacuated ASAP when the patient is breathing over 30 breaths per minute, or is breathing normally but has an absent radial pulse, or is breathing normally with radial pulse but has an abnormal level of responsiveness?

In the START (Simple Triage and Rapid Treatment) system, the classification of patients is critical for effective triage during a mass casualty incident. The red tag is assigned to individuals who require immediate medical intervention due to life-threatening conditions. Specifically, a patient should receive a red tag if they are breathing more than 30 breaths per minute, indicating potential respiratory distress or failure. Additionally, if a patient has a normal respiratory rate but does not have a radial pulse, it suggests a possible circulatory compromise requiring urgent attention. Lastly, if a patient’s responsiveness is abnormal—regardless of their respiratory or pulse status—it indicates a need for immediate evaluation and treatment.

This prioritization is essential for maximizing survival, identifying those who can be stabilized quickly, and ensuring that resources are directed to those in greatest need. Individuals with red tags represent the most critical patients who cannot be delayed in receiving care and must be evacuated as soon as possible.