START Triage Mass-Casualty Drill
A drill in which rescue teams sort several victims spread across the field using the START triage method: walking, breathing, respiratory rate, and response. Students practice decision-making under pressure, teamwork, and setting care priorities.
How to play
- Explanation (5 min): START flowchart on a poster with four colors: green can walk, red immediate, yellow can wait, black not breathing after opening the airway.
- Five groups of 5. One group plays victims, each with a hidden condition card, lying in a coned area 30 yards away.
- On the signal, a team runs out and has 3 minutes to triage everyone: ask if they can walk, check breathing and whether they follow commands, and drop a pinnie of the chosen color.
- Debrief: one point per correctly triaged victim and a bonus point for finishing on time.
- Rotate so every group plays victims and rescuers (about 4 minutes per round), shuffling the cards.
Rules
- Safety: nobody lifts or moves a victim.
- Victims give no clues beyond their card.
- Max 30 seconds per victim: sort, don't treat.
- Walk inside the victim area so nobody gets stepped on.
Variations
Easier
Use only three colors, and victims say their main symptom out loud.
Standard
Full START flowchart with 5 victims per round and 3 minutes to triage them.
Harder
Victims change condition mid-round and the team gives a final mock radio report to 911 dispatch.
Adaptations
- Limited mobility: coordinator at base recording colors and times.
- Students with autism: flowchart always in view and a fixed role next to a partner.
- Lower fitness: victim area at 15 yards, approached at a brisk walk.
Learning goals
- Apply the START method to set care priorities.
- Make quick, reasoned decisions under pressure.
- Coordinate a rescue team with clear communication.
Equipment for a class of 25
- cards: 25
- pinnies: 20
- cones: 8
- stopwatch: 1
Teacher tip
Prepare cards with mixed conditions and a trick case, like a victim who screams but can walk. In the debrief, remind students that scene safety always comes first.
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