A nurse is triaging patients in the emergency department following a chemical spill incident. Using the START (Simple Triage and Rapid Treatment) system, which patient should receive the highest priority (RED tag)?

Core Principle: The goal of triage shifts from individual-focused care to providing the greatest good for the greatest number. The START system uses the RPM mnemonic (Respirations, Perfusion, Mental Status) to rapidly sort patients in under 60 seconds per patient.

RPM Algorithm Flow:

1. Respirations: If apneic, manually open the airway. If breathing resumes, tag RED. If still apneic, tag BLACK. If breathing spontaneously, assess rate. A rate over 30/min or under 10/min tags RED. A normal rate triggers the next step.
2. Perfusion: Check radial pulse or capillary refill. Absent radial pulse or capillary refill over 2 seconds indicates shock and tags RED. A present radial pulse triggers the next step.
3. Mental Status: Assess ability to follow simple commands (e.g., "Squeeze my hand"). If the patient cannot follow commands, tag RED. If they can, tag YELLOW (Delayed).

Special Consideration: All ambulatory patients who can walk to a designated area are immediately tagged GREEN (Minor) and are the lowest priority. They are only reassessed after all non-ambulatory patients are triaged. Do not delay the sorting process by treating injuries during the initial triage sweep.