can rapidly assess the remaining patients who are either expectant or are in need of immediate aid. From that point, the first responder is quickly able to identify those in need of immediate attention while not being distracted or overwhelmed by the magnitude of the situation. Using this method assumes the ability to hear. Deaf, partially deaf, or victims of a large blast injury may not be able to hear these instructions. Scoring systems The following are examples of scoring systems used: In Western Europe the Triage Revised Trauma Score (TRTS) is sometimes used and integrated into triage cards. The Injury Severity Score (ISS) is another example of a trauma scoring system. This assigns a score from 0 to 75 based on severity of injury to the human body divided into three categories: A (face/neck/head), B(thorax/abdomen), C(extremities/external/skin). Each category is scored from 0 to 5 using the Abbreviated Injury Scale, from uninjured to critically injured, which is then squared and summed to create the ISS. A score of 6, for "unsurvivable", can also be used for any of the three categories, and automatically sets the score to 75 regardless of other scores. Depending on the triage situation, this may indicate either that the patient is a first priority for care, or that he or she will not receive care owing to the need to conserve care for more likely survivors. S.T.A.R.T. model S.T.A.R.T. (Simple Triage and Rapid Treatment) is a simple triage system that can be performed by lightly trained lay and emergency personnel in emergencies. It is not intended to supersede or instruct medical personnel or techniques. It has been taught to California emergency workers for use in earthquakes. It was developed at Hoag Hospital in Newport Beach, California for use by emergency services. It has been field-proven in mass casualty incidents such as train wrecks and bus accidents, though it was developed by community emergency response teams (CERTs) and firefighters after earthquakes. Triage separates the injured into four groups: The expectant who are beyond help The injured who can be helped by immediate transportation The injured whose transport can be delayed Those with minor injuries who need help less urgently Triage also sets priorities for evacuation and transport as follows: Deceased are left where they fell. These include those who aren't breathing and repositioning their airway efforts were unsuccessful. Immediate or Priority 1 (red) evacuation by MEDEVAC if