You arrive at a school bus accident with multiple pediatric patients. Chaos is erupting, and parents are screaming. You have 30 seconds to decide who gets treated first and who can wait. This is where JumpSTART Triage takes over.
What is JumpSTART Triage?
JumpSTART Triage (Jump Simple Triage and Rapid Treatment) is a standardized MCI triage system specifically designed for pediatric patients (generally ages 1 to 8 or up to approximately 50 lbs). It adapts the adult START algorithm to account for the physiological differences in children, specifically their unique respiratory drives and compensatory mechanisms.
Why JumpSTART Triage Matters in the Field
Children compensate for shock differently than adults—they maintain blood pressure until they crash. In an MCI, using adult protocols might cause you to miss a critically ill child because you’re checking for a radial pulse that is naturally difficult to feel. Recognizing these differences ensures the sickest kids get immediate transport while preventing the EMS system from being overwhelmed by the “walking wounded.”
What You’ll Actually See
You’ll move quickly through the scene, first asking anyone who can walk to move to a designated area. For non-ambulatory children, you assess respirations first. If a child isn’t breathing, you open the airway—if they start breathing, they are tagged Immediate (Red); if not, they are Expectant (Black). You’ll check capillary refill instead of a radial pulse, and assess mental status by asking them to squeeze your fingers.
“Pediatric patient, age 4, found conscious but lethargic. Respirations are 35 and shallow, capillary refill is 4 seconds. Unable to follow commands. Tagged Immediate.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Attempting to palpate a radial pulse on a frightened, cold, or hypovolemic child. You will likely feel nothing, leading you to incorrectly tag a critical patient as “Expectant” or “Delayed.”
💡 Pro Tip: Use Capillary Refill Time (CRT) at the sternum or forehead to assess perfusion. A CRT > 2 seconds is a sign of shock in a pediatric MCI. Also, remember that a respiratory rate over 30 is a significant red flag in kids, unlike in adults.
Memory Aid for JumpSTART Triage
Remember “Kids Breathe First.” In adults, we worry about the heart (pulse) stopping; in kids, we worry about the lungs (respirations) stopping. JumpSTART prioritizes the airway and breathing assessment over circulation checks more aggressively than adult triage.
NREMT Connection
NREMT exams often include MCI scenarios with a mix of adults and children. The test writers are checking to see if you automatically switch to JumpSTART logic when the patient is under 8 years old, specifically checking CRT and respiratory rate thresholds rather than relying solely on blood pressure or radial pulses.
Related Concepts
This system is the pediatric counterpart to START Triage, used for adult patients. It relies heavily on understanding the Pediatric Assessment Triangle and normal vital sign ranges for children, particularly the distinction between normal respiratory rates for age. You must also know SALT Triage as a newer alternative, but JumpSTART remains the standard for pediatric-specific MCIs.
Quick Reference
✓ Age range: 1–8 years (or < 50 lbs) ✓ Priority level: MCI Triage System ✓ Treatment considerations: • Assess walking ability first (Green tag) • Open airway for apnea; tag Red if breathing resumes • Resp rate < 15 or > 30 = assess perfusion/mental status • Use Capillary Refill > 2 sec for shock assessment • Inappropriate mental status = Immediate (Red)
When the scene is full of kids, keep your head on a swivel and trust the JumpSTART algorithm—it’s designed to catch the subtle signs of pediatric shock that adult protocols miss.