RPM-30-2-Can Do
RPM-30-2-Can Do is a mnemonic device for the criteria used in the START triage system, which is used to sort patients into categories at a mass casualty incident.[1][2][3] The mnemonic is pronounced "R, P, M, thirty, two, can do."
Mnemonic for adult triage
[edit]Using the START system, GREEN (MINOR) patients are easily identified by their ability to walk to a designated treatment area when told to do so immediately after the first responders' arrival.[4]
Deceased patients are easily identified by apnea with no return of spontaneous respirations when their airway is repositioned. These patients are triaged BLACK (EXPECTANT/DECEASED).[4]
"RPM-30-2-Can do" helps responders differentiate between the other two triage categories: YELLOW (DELAYED) and RED (IMMEDIATE). "30, 2, Can Do" stands for the criteria that delineate these two categories:
- Respirations: Is the patient's respiratory rate over 30 per minute?
- Perfusion: Is capillary refill over or under 2 seconds?
- Mental status: Is the patient able to follow simple commands (the patient can do what you ask them to)?
To be triaged YELLOW (DELAYED) , the patient must meet all of these criteria:
| R | 30 | Respiratory rate is under 30 per minute. |
| P | 2 | Perfusion is adequate, indicated by capillary refill under 2 seconds.[4] |
| M | Can Do | Mental status is adequate, indicated by the patient's ability to follow simple commands (the patient can do what they are asked) |
If any one of these criteria are not met, the patient is triaged RED (IMMEDIATE).
Inclusion of pediatric criteria
[edit]An alternative version of this mnemonic is RPM-30-2-Can Do-15-45. The "15-45" at the end refers to the different respiratory criteria in the pediatric JumpSTART triage system, due to the differences between children's and adults' normal respiratory rates.[5]
In pediatric patients:
- Children who are breathing under 15 times a minute are RED.[5]
- Children who are breathing over 45 times a minute are RED.[5]
The remainder of the criteria are the same as those specified in the adult acronym, except that an apneic child is given five assisted ventilations before being triaged Black. A child who starts breathing on their own after five ventilations is triaged RED; a child without spontaneous return of respirations is triaged BLACK.[5]
See also
[edit]References
[edit]- ^ Kanten, Benjamin S. (April 20, 2013). Do You Know Where to START in a Disaster? (Speech). National Commission on Correctional Health Care Spring Conference on Correctional Health Care, Denver, Colorado. Retrieved February 10, 2016.
- ^ Markovchick, Vincent J.; Pons, Peter T.; Bakes, Katherine M.; Buchanan, Jennie A. (2016). Emergency Medicine Secrets (6th ed.). Philadelphia: Elsevier. p. 663. ISBN 978-0-323-35516-2.
- ^ Husted, Ernie (April 15, 2011). "Principles of Triage During a Mass Casualty Incident" (PDF). OhioResponds: Emergency Preparedness. Ohio Department of Health, Office of Health Preparedness. pp. 44–49. Archived from the original (PDF) on 2016-11-10. Retrieved February 9, 2016.
- ^ a b c "START Triage Adult Algorithm". Chemical Hazards Emergency Medical Management. United States National Library of Medicine, National Institutes of Health. October 31, 2014. Retrieved February 9, 2016.
- ^ a b c d "JumpSTART Pediatric Triage Algorithm". Chemical Hazards Emergency Medical Management. United States National Library of Medicine, National Institutes of Health. June 25, 2011. Retrieved February 9, 2016.