The Simple Triage and Rapid Treatment (START) method, developed in 1983, is a triage system used by first responders during mass casualty incidents (MCI) to categorize victims based on the severity of their injuries within a 30-60 second assessment [1] [3]. It is a scene management system that quickly divides patients into four priority groups [3] [5]. The original START algorithm used the ability to obey commands, respiratory rate, and capillary refill to assign triage category [2]. A modification in 1996 replaced capillary refill with radial pulse check [2]. The radial pulse is found on the thumb side of the wrist, between the midline and the radius bone [7]. This triage system prioritizes the greatest good for the greatest number of people, with minimal treatment during triage, which is counterintuitive to normal pre-hospital protocols [8].