急診室應對一起化工廠爆炸引起的大量傷患事件 (MCI)。檢傷護理師在現場使用 START (簡單檢傷與快速處置) 方法。目前面對四名傷患：傷患1死前喘息，暢通呼吸道後停止呼吸且無脈搏；傷患2顳動脈大出血，呼吸 32次/分且意識混亂；傷患3大腿開放性骨折，呼吸 22次/分且橈動脈強健；傷患4歇斯底里大哭但可自行步行至治療區。下列哪些檢傷掛牌標示是正確的？（多選題）
An emergency department responds to a mass casualty incident (MCI) following a chemical plant explosion. The triage nurse uses the START (Simple Triage and Rapid Treatment) method in the field. Four victims are presented: Victim 1 has agonal breathing that ceases after unblocking the airway, absent pulses; Victim 2 has a profusely bleeding temporal laceration, RR 32/min, and is confused; Victim 3 has an open femur fracture, RR 22/min, and strong radial pulses; Victim 4 is crying hysterically but walks to the treatment area. Which triage tagging actions are correct? (Select all that apply.)
- ATag Victim 1 as RED (Immediate) because they require immediate cardiopulmonary resuscitation.將傷患1標記為紅色（Immediate），因為他們需要立即心肺復甦術。
- BTag Victim 1 as BLACK (Expectant) because breathing does not resume after positioning the airway.✓ 正解將傷患1標記為黑色（Expectant），因為在調整呼吸道姿勢後呼吸未恢復。
- CTag Victim 2 as RED (Immediate) due to rapid respiratory effort and impaired mental status.✓ 正解將傷患2標記為紅色（Immediate），由於快速的呼吸努力和受損的精神狀態。
- DTag Victim 3 as RED (Immediate) strictly because an open fracture poses a high risk of bone infection.將傷患3標記為紅色（Immediate）， solely 因為開放性骨折構成高骨骼感染風險。
- ETag Victim 4 as GREEN (Minor) because they are able to walk independently.✓ 正解將傷患4標記為綠色（Minor），因為他們能夠獨立行走。
本題測驗災難大量傷患（MCI）的 START 檢傷分類法。災難檢傷的核心不同於常規急診，其宗旨為「分配有限資源以拯救最多生命」。在評估呼吸時：若暢通呼吸道後仍無呼吸（如傷患1），在資源稀缺現場不會進行 CPR，而是標註為黑色（預期死亡 / Expectant，選項B正確，選項A錯誤）。若病患呼吸次數 > 30 次/分、微血管充血時間 > 2秒或無橈動脈、或無法遵循簡單指令（意識改變），則標為紅色（立即介入 / Immediate），傷患2符合呼吸過快及意識混亂的條件（選項C正確）。對於受傷嚴重但呼吸 < 30、脈搏正常且能聽從指令者（如傷患3），屬黃色（延遲介入 / Delayed，選項D錯誤）。凡是能自行步行的傷患（如傷患4），統一歸類為綠色（輕傷 / Minor，選項E正確）。
This item tests the START triage method used in mass casualty incidents (MCIs). The core principle of disaster triage differs from routine emergency care: its purpose is to allocate limited resources to save the greatest number of lives. When assessing breathing: if the airway has been opened but the victim still does not breathe (as with Victim 1), CPR is not initiated at a resource-scarce scene; instead the victim is tagged Black (Expectant — option B correct, option A incorrect). If the patient has a respiratory rate > 30/min, capillary refill > 2 seconds or absent radial pulse, or cannot follow simple commands (altered mentation), they are tagged Red (Immediate); Victim 2 meets the criteria of tachypnea and confusion (option C correct). For victims with serious injuries but RR < 30, intact pulses, and the ability to follow commands (like Victim 3), the appropriate tag is Yellow (Delayed) — option D incorrect. Any ambulatory victim (like Victim 4) is uniformly classified as Green (Minor — option E correct).
台灣與美國的災難急診均沿用 START (Simple Triage and Rapid Treatment) 分類系統，黑、紅、黃、綠的判定標準與邏輯在兩國醫療現場完全共通。