In START-style triage used in SAR, what criteria categorize casualties, and what do the categories mean?

• A. Weather, terrain, hazards, and equipment status.
• B. Respirations, perfusion, mental status; Immediate (life-threatening), Delayed, Minor, and Expectant.
• C. Breathing rate only; Immediate or Non-Immediate.
• D. Movement and limb sensation; Critical, Urgent, Moderate, Minor.

Answer: (C)

In START-style triage the speed and visibility of life threats are evaluated using three quick physiological checks, and those results sort casualties into four urgency categories: Immediate, Delayed, Minor, and Expectant. The checks are chosen because they reveal, in a few seconds, whether a person is still circulating blood, able to breathe adequately, and able to follow basic instructions.

First, breathing status after establishing an open airway is assessed. If the person isn’t breathing, they’re identified as a high priority because without air, they won’t survive without rapid intervention. If they are breathing but their rate is very fast (about 30 breaths per minute or more), that signals serious distress and a need for immediate care.

Next, perfusion is checked. This looks at whether blood is circulating effectively, often by feeling for a central or peripheral pulse and noting capillary refill. Poor perfusion—no pulse or very slow refill—means the person is at high risk and requires immediate attention.

Finally, mental status is assessed by asking the person to follow simple commands. The ability to follow commands usually indicates the injuries aren’t instantly life-threatening and helps determine if the casualty can be moved to a treatment area with others (delayed or minor). If the person cannot follow commands but isn’t in immediate danger, there’s another level of prioritization to manage with remaining resources. Those who are ambulatory or minimally injured can be classified as Minor, while those with grave injuries and low chance of survival given current resources may be tagged as Expectant, receiving comfort care rather than active life-saving interventions.

Putting it together, the four categories represent severity and need for intervention: Immediate (life-threatening but salvageable with rapid care), Delayed (injuries that can wait a short while), Minor (walking wounded with minimal injuries), and Expectant (not expected to survive with available resources, focus on comfort). This triage framework lets responders quickly allocate attention and evac resources to those most likely to benefit.