scholarly journals Prehospital Triage by Lay Person First Responders: A Scoping Review and Proposal for a new Prehospital Triage Tool

2021 ◽  
pp. 1-11
Author(s):  
Wesley D Jetten ◽  
Jeroen Seesink ◽  
Markus Klimek
Keyword(s):  
Scoping Review ◽  
Life Support ◽  
First Responders ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Lay People ◽  
Online Databases ◽  
Healthcare Experience ◽  
Prehospital Triage

Abstract Objective: The primary aim of this study is to review the available tools for prehospital triage in case of mass casualty incidents and secondly, to develop a tool which enables lay person first responders (LPFRs) to perform triage and start basic life support in mass casualty incidents. Methods: In July 2019, online databases were consulted. Studies addressing prehospital triage methods for lay people were analyzed. Secondly, a new prehospital triage tool for LPFRs was developed. Therefore, a search for prehospital triage models available in literature was conducted and triage actions were extracted. Results: The search resulted in 6188 articles, and after screening, a scoping review of 4 articles was conducted. All articles stated that there is great potential to provide accurate prehospital triage by people with no healthcare experience. Based on these findings, and combined with the pre-existing prehospital triage tools, we developed a, not-yet validated, prehospital triage tool for lay people, which may improve disaster awareness and preparedness and might positively contribute to community resilience. Conclusion: The prehospital triage tool for lay person first responders may be useful and may help professional medical first responders to determine faster, which casualties most urgently need help in a mass casualty incident.

How will disaster victims react to first responder commands—A survey of simulated disaster victims

2020 ◽  
Vol 15 (4) ◽  
pp. 275-282
Author(s):  
Sophie Monnier-Serov, MD, MPH ◽  
Abhinav Gupta, MD ◽  
Virginia Mangolds, PhD, FNP-C, ENP-C ◽  
John P. Broach, MD, MPH, MBA, FACEP ◽  
Laurel O’Connor, MD ◽  
...  
Keyword(s):  
First Responders ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Maladaptive Behavior ◽  
Disaster Victims ◽  
Healthcare Experience ◽  
Receive Treatment ◽  
To Receive ◽  
Question Survey ◽  
Disaster Exposure

Objective: To determine whether victim behavior and interaction with triage personnel would conform to expected actions as dictated by the Simple Triage and Rapid Treatment (START) triage methodology, which emphasizes that victims will accept their assigned triage category.Methods: In total, 105 volunteers were recruited to complete a 32-question survey after portraying victims in a triage-focused mass casualty incident (MCI) simulation. Questions included sociodemographic characteristics, willingness to follow commands of first responders, and willingness to help first responders. The authors examined whether the outcomes differed by demographics, healthcare experience, or disaster exposure of participants.Results: The survey response rate was 90 percent (95/105). The mean age of participants was 31 years (58 percent women). Half of respondents indicated that they would ask responders to change their triage color if they disagreed with it and 75 percent would ask first responders to change their friend or family members’ triage colors. Twenty-one percent of victims reported that they would alter their own triage tag to receive treatment faster and 38 percent would alter a friend or family member’s triage color. The youngest (20 years) and oldest (40 years) respondents were most likely to act maladaptively.Conclusion: Triage algorithms rely upon victims following the instructions of rescuers. This study suggests that maladaptive behavior by some victims should be anticipated.

scholarly journals A translational triage research development tool: standardizing prehospital triage decision-making systems in mass casualty incidents

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Amir Khorram-Manesh ◽  
Johan Nordling ◽  
Eric Carlström ◽  
Krzysztof Goniewicz ◽  
Roberto Faccincani ◽  
...  
Keyword(s):  
Decision Making ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Future Research ◽  
Triage System ◽  
Universal System ◽  
Global Consensus ◽  
Development Tool ◽  
Prehospital Triage ◽  
Evidence Review

Abstract Background There is no global consensus on the use of prehospital triage system in mass casualty incidents. The purpose of this study was to evaluate the most commonly used pre-existing prehospital triage systems for the possibility of creating one universal translational triage tool. Methods The Rapid Evidence Review consisted of (1) a systematic literature review (2) merging and content analysis of the studies focusing on similarities and differences between systems and (3) development of a universal system. Results There were 17 triage systems described in 31 eligible articles out of 797 identified initially. Seven of the systems met the predesignated criteria and were selected for further analysis. The criteria from the final seven systems were compiled, translated and counted for in means of 1/7’s. As a product, a universal system was created of the majority criteria. Conclusions This study does not create a new triage system itself but rather identifies the possibility to convert various prehospital triage systems into one by using a triage translational tool. Future research should examine the tool and its different decision-making steps either by using simulations or by experts’ evaluation to ensure its feasibility in terms of speed, continuity, simplicity, sensitivity and specificity, before final evaluation at prehospital level.

scholarly journals A need for prehospital triage standardizing tool in mass casualty incidents

2021 ◽  
Author(s):  
Amir Khorram-Manesh ◽  
Johan Nordling ◽  
Eric Carlström ◽  
Krzysztof Goniewicz ◽  
Roberto Faccincani ◽  
...  
Keyword(s):  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Prehospital Triage

scholarly journals Modeling Uncertain and Dynamic Casualty Health in Optimization-Based Decision Support for Mass Casualty Incident Response

2015 ◽  
pp. 411-423
Author(s):  
Duncan T. Wilson ◽  
Glenn I. Hawe ◽  
Graham Coates ◽  
Roger S. Crouch
Keyword(s):  
Decision Support ◽  
Real Time ◽  
Health Assessment ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Support Program ◽  
Dynamic Nature ◽  
Significant Challenge ◽  
Health Model

When designing a decision support program for use in coordinating the response to Mass Casualty Incidents, the modelling of the health of casualties presents a significant challenge. In this paper we propose one such health model, capable of acknowledging both the uncertain and dynamic nature of casualty health. Incorporating this into a larger optimisation model capable of use in real-time and in an online manner, computational experiments examining the effect of errors in health assessment, regular updates of health and delays in communication are reported. Results demonstrate the often significant impact of these factors.

scholarly journals Real-Time Monitoring Electronic Triage Tag System for Improving Survival Rate in Disaster-Induced Mass Casualty Incidents

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 877
Author(s):  
Ju Young Park
Keyword(s):  
Survival Rate ◽  
Vital Sign ◽  
Disaster Response ◽  
Electricity Consumption ◽  
Mass Casualty ◽  
Ease Of Use ◽  
Mass Casualty Incidents ◽  
Design Development ◽  
Prehospital Triage ◽  
Rapid Prototyping Model

This study was conducted to contribute to active disaster response by developing internet of things (IoT)-based vital sign monitoring e-triage tag system to improve the survival rate at disaster mass casualty incidents fields. The model used in this study for developing the e-triage tag system is the rapid prototyping model (RAD). The process comprised six steps: analysis, design, development, evaluation, implementation, and simulation. As a result of detailed assessment of the system design and development by an expert group, areas with the highest score in the triage sensor evaluation were rated “very good”, with 5 points for continuous vital sign data delivery, portability, and robustness. In addition, ease of use, wearability, and electricity consumption were rated 4.8, 4.7, and 4.6 points, respectively. In the triage application evaluation, the speed and utility scored a perfect 5 points, and the reliability and expressiveness were rated 4.9 points and 4.8 points, respectively. This study will contribute significantly to increasing the survival rate via the development of a conceptual prehospital triage for field applications and e-triage tag system implementation.

scholarly journals Confusion, Chaos, and Bridging the Gap: A Prospective Study Gauging Disaster Triage Methodologies and Usage Across First Responder Professions

2019 ◽  
Vol 34 (s1) ◽  
pp. s111-s111
Author(s):  
Brenna Adelman
Keyword(s):  
National Policy ◽  
First Responders ◽  
The United States ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Future Research ◽  
Field Triage ◽  
Mass Casualty Event ◽  
A Prospective Study ◽  
National Trends

Introduction:Disasters are unique in that they impact all socioeconomic, class, and social divides. They are complex, hard to conceptualize and operationally define, and occur sporadically without warning. However, regardless of each disasters innate unpredictability, there is one common need that directly impacts patient morbidity and mortality: effective triage.Aim:Currently the United States has no uniform triage mandate. The purpose of this study is to gather descriptive data on the type of mass-casualty triage currently being utilized by first responders (Emergency Medical Services/Fire/Nurses) and improve our understanding regarding the prevalence of mass casualty triage.Methods:A descriptive mixed methods survey is being distributed to first responders/nurses in the Appalachian region. This survey collects respondents demographics, profession, and MCI triage data. Data will be analyzed and descriptive statistics will be generated. GIS will be utilized to graph findings and visualize local and national trends.Results:Results of this study are pending.Discussion:Organizations have addressed the need for a standard triage protocol, even going so far as to create uniform criteria which each triage system should meet. However, the literature does not describe how individual professions train their members in disaster triage, or what triage is currently being utilized in each profession. Nurses and first-responders serve as linchpins in many communities. They remain in a community, both before, during, and after a mass casualty event, but they do not perform in a vacuum. During an MCI (mass-casualty incident) their scope of practice may vary, but they have common foci: the affected community. A better understanding of the type of MCI triage that each profession is using is vital in understanding how triage is being applied, and vital in identifying gaps in application that may impact the effectiveness of field triage, and affect local and national policy, practice, and future research.

scholarly journals Using Immersive Simulation for Training First Responders for Mass Casualty Incidents

2008 ◽  
Vol 15 (11) ◽  
pp. 1152-1159 ◽  
Author(s):  
William Wilkerson ◽  
Dan Avstreih ◽  
Larry Gruppen ◽  
Klaus-Peter Beier ◽  
James Woolliscroft
Keyword(s):  
First Responders ◽  
Mass Casualty ◽  
Mass Casualty Incidents

Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States

2016 ◽  
Vol 31 (2) ◽  
pp. 141-149 ◽  
Author(s):  
Mazen El Sayed ◽  
Hani Tamim ◽  
N. Clay Mann
Keyword(s):  
Emergency Medical Services ◽  
Life Support ◽  
The United States ◽  
Medication Administration ◽  
Service Level ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Medical Services ◽  
Service Levels ◽  
Emergency Medical

AbstractBackgroundEmergency Medical Services (EMS) preparedness and availability of essential medications are important to reduce morbidity and mortality from mass-casualty incidents (MCIs).ObjectivesThis study describes prehospital medication administration during MCIs by different EMS service levels.MethodsThe US National EMS Public-Release Research Dataset maintained by the National Emergency Medical Services Information System (NEMSIS) was used to carry out the study. Emergency Medical Services activations coded as MCI at dispatch, or by EMS personnel, were included. The Center for Medicare and Medicaid Services (CMS) service level was used for the level of service provided. A descriptive analysis of medication administration by EMS service level was carried out.ResultsAmong the 19,831,189 EMS activations, 53,334 activations had an MCI code, of which 26,110 activations were included. There were 8,179 (31.3%) Advanced Life Support (ALS), 5,811 (22.3%) Basic Life Support (BLS), 399 (1.5%) Air Medical Transport (AMT; fixed or rotary), and 38 (0.2%) Specialty Care Transport (SCT) activations. More than 80 different medications from 18 groups were reported. Seven thousand twenty-one activations (26.9%) had at least one medication administered. Oxygen was most common (16.3%), followed by crystalloids (6.9%), unknown (5.2%), analgesics (3.2%) mainly narcotics, antiemetics (1.5%), cardiac/vasopressors/inotropes (0.9%), bronchodilators (0.9%), sedatives (0.8%), and vasodilators/antihypertensives (0.7%). Overall, medication administration rates and frequencies of medications groups significantly varied between EMS service levels (P<.01) except for “Analgesia (other)” (P=.40) and “Pain medications (nonsteroidal anti-inflammatory drug; NSAID)” (P=.07).ConclusionMedications are administered frequently in MCIs, mainly Oxygen, crystalloids, and narcotic pain medications. Emergency Medical Services systems can use the findings of this study to better prepare their stockpiles for MCIs.El SayedM, TamimH, MannNC. Description of medication administration by Emergency Medical Services during mass-casualty incidents in the United States. Prehosp Disaster Med. 2016;31(2):141–149.

Defining the Problem, Main Objective, and Strategies of Medical Management in Mass-Casualty Incidents Caused by Terrorist Events

2008 ◽  
Vol 23 (1) ◽  
pp. 82-89 ◽  
Author(s):  
Itamar Ashkenazi ◽  
Boris Kessel ◽  
Oded Olsha ◽  
Tawfik Khashan ◽  
Meir Oren ◽  
...  
Keyword(s):  
Medical Management ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Traditional Management ◽  
Treat Ment ◽  
Impact On Survival ◽  
Life Threatening ◽  
Management Roles ◽  
Terrorist Events

AbstractBased on the experience of managing >20 such events during the last decade, the authors' understanding of a mass-casualty incident is that it is an event in which there may be many victims, but only a few that actually suffer from life-threatening injuries. To make an impact on survival, one must identify those who are severely wounded as quickly as possible and offer those patients opti-mal care. Experienced trauma physicians are the most important resource available to achieve this objective, and they should be allocated to the treat-ment of seriously injured victims instead of more traditional management roles such as triage and incident manager.

Reconsidering Policy of Casualty Evacuation in a Remote Mass-Casualty Incident

2013 ◽  
Vol 29 (1) ◽  
pp. 91-95 ◽  
Author(s):  
Bruria Adini ◽  
Robert Cohen ◽  
Elon Glassberg ◽  
Bella Azaria ◽  
Daniel Simon ◽  
...  
Keyword(s):  
Injury Severity ◽  
Life Support ◽  
Tertiary Care ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Care Hospital ◽  
Publication Type ◽  
Local Hospital ◽  
Trauma Surgeons

AbstractObjectivesInappropriate distribution of casualties in mass-casualty incidents (MCIs) may overwhelm hospitals. This study aimed to review the consequences of evacuating casualties from a bus accident to a single peripheral hospital and lessons learned regarding policy of casualty evacuation.MethodsMedical records of all casualties relating to evacuation times, injury severity, diagnoses, treatments, resources utilized and outcomes were independently reviewed by two senior trauma surgeons. In addition, four senior trauma surgeons reviewed impact of treatment provided on patient outcomes. They reviewed the times for the primary and secondary evacuation, injury severity, diagnoses, surgical treatments, resources utilized, and the final outcomes of the patients at the point of discharge from the tertiary care hospital.ResultsThirty-one survivors were transferred to the closest local hospital; four died en route to hospital or within 30 minutes of arrival. Twenty-seven casualties were evacuated by air from the local hospital within 2.5 to 6.15 hours to Level I and II hospitals. Undertriage of 15% and overtriage of seven percent were noted. Four casualties did not receive treatment that might have improved their condition at the local hospital.ConclusionsIn MCIs occurring in remote areas, policy makers should consider revising the current evacuation plan so that only immediate unstable casualties should be transferred to the closest primary hospital. On site Advanced Life Support (ALS) should be administered to non-severe casualties until they can be evacuated directly to tertiary care hospitals. First responders must be trained to provide ALS to non-severe casualties until evacuation resources are available.AdiniB, CohenR, GlassbergE, AzariaB, SimonD, SteinM, KleinY, PelegK. Reconsidering policy of casualty evacuation in a remote mass-casualty incident. Prehosp Disaster Med. 2013;28(6):1-5.

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