Triage Decisions of United Kingdom Police Firearms Officers Using a Multiple-Casualty Scenario Paper Exercise

2005 ◽  
Vol 20 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Tim Kilner ◽  
F. John Hall
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Police Officers ◽  
Medical Training ◽  
Clinical Skills ◽  
Support Material ◽  
Support Materials ◽  
Triage Decision ◽  
Severity Of Injury ◽  
Triage Decisions

AbstractIntroduction:British police officers authorized to carry firearms may need to make judgments about the severity of injury of individuals or the relative priority of clinical need of a group of injured patients in tactical and non-tactical situations. Most of these officers receive little or no medical training beyond basic first aid to enable them to make these clinical decisions. Therefore, the aim of this study is to determine the accuracy of triage decision-making of firearms-trained police officers with and without printed decision-support materials.Methods:Eighty-two police firearms officers attending a tactical medicine course (FASTAid) were recruited to the study. Data were collected using a paper-based triage exercise that contained brief, clinical details of 20 adults and 10 children. Subjects were asked to assign a clinical priority of immediate or priority 1 (P1); urgent or priority 2 (P2); delayed or priority 3 (P3); or dead, to each casualty. Then, they were provided with decision-making materials, but were not given any instruction as to how these materials should be used. Subjects then completed a second triage exercise, identical to the first, except this time using the decision-support materials.Data were analyzed using mixed between-within subjects analysis of variance. This allowed comparisons to be made between the scores for Exercise 1 (no decision-support material) and Exercise 2 (with decision-support material). It also allowed any differences between those students with previous triage training and those without previous training to be explored.Results:The use of triage decision-making materials resulted in a significant increase in correct responses (p <0.001). Improvement in accuracy appears to result mainly from a reduction in the extent of under-triage. There were significant differences (p <0.05) between those who had received previous triage training and those who had not, with those having received triage training doing slightly better.Conclusion:It appears that significant improvements in the accuracy of triage decision-making by police firearms officers can be achieved with the use of appropriate triage decision-support materials. Training may offer additional improvements in accuracy, but this improvement is likely to be small when decision-support materials are provided. With basic clinical skills and appropriate decision-support materials, it is likely that the police officer can make accurate triage decisions in a multiple-casualty scenario or make judgments of the severity of injury of a given individual in both tactical and non-tactical situations.

Triage Nurses Decision-Support Application Design

2018 ◽  
Vol 7 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Tamari Levis ◽  
Dagan Schwartz ◽  
Yuval Bitan
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Medical Condition ◽  
Data Gathering ◽  
Severity Index ◽  
Triage Decision ◽  
Planning And Design ◽  
Frequent Use ◽  
Current Design ◽  
Decision Making Model

In this paper, we will present the planning and design process of a triage decision-support application, aimed to be used for both research data gathering and real-time triage decision-making. Triage is an initial classification of emergency department (ED) patients, according to the severity level of their medical condition. The need of fast and accurate triage decision-making, lead to the development of widely used triage algorithms, such as ESI (Emergency Severity Index). Observations and interviews with triage personnel exposed difficulties of triage process and helped us create an ESI-based decision making model. Next, we built a multiple-choice questioner to characterize the application and required features. 40 triage nurses completed the questioner. Results indicated that the most highly requested feature was an automated severity grade calculator, which became the core of the proposed design. While current design focuses on the analytical decision model, statistical analysis of the questioner results indicated that it is often insufficient when facing medical reality complexities, dictating nurse’s frequent use of intuition. Using triage systems data analysis and modern machine-learning methodologies, we inspire to develop a second version of the application that will integrate intuitive insights into triage scale algorithmic decision process.

Herding cats: ethics in prehospital triage

2021 ◽  
Keyword(s):  
Decision Making ◽  
Moral Rights ◽  
Assessment Criteria ◽  
Ethical Framework ◽  
Triage Decision ◽  
Prehospital Triage ◽  
Prehospital Emergency ◽  
Ethical Approaches ◽  
Historical Basis ◽  
Triage Decisions

Objective: Triage can create an ethical slippery slope when providing prehospital emergency health care. In triage decisions, emergency management is like the idiom of “herding cats”, which refers to managing or controlling the chaos and organizing people toward common goals. The purpose of this literature review is to explore the ethical framework of prehospital triage and to provide a critical view of the subject. Methods: Published materials related to “triage”, “ethics”, and “prehospital emergency medicine” were extracted from online databases and books from 1985 until February 2021. The papers were handled in seven themes including the historical basis, the importance of the triage, ethical considerations in prehospital triage, justice, assessment and decision-making, the variability of triage assessment criteria, and the reliability of triage decisions. Except for the historical basis and the importance of triage, the other five groups were discussed with an ethical critique of the content. The methodology in this article is based on a critical interpretation of discussions on triage through ethical approaches. Results: There are three basic ethical approaches to triage: utilitarianism, beneficence, and justice. Due to the historical military basis of triage, results-focused approaches have become more prominent. Ethical values in prehospital triage include the issues of human rights, moral rights, social justice, and beneficence. Ethical difficulties in triage decision-making involve vulnerability, limited resources, the concern of safety, the urgency of the situation, and instability. Triage decisions may be affected by subjective approaches such as the personal values and beliefs of the decision-makers. Conclusions: Three predominant ethical concepts in triage are utilitarianism, beneficence, and justice. The unique dynamics of the field influence triage decision-making in a variety of ways. The way triage is structured makes it more amenable to subjective influences. Considering the differences in prehospital triage models and approaches, there is an important need for an ethical framework that expresses clear values and principles that will guide prehospital emergency caregivers. In this paper, it is suggested that an ethical framework should include the following six headings: basic bioethical principles, distributing scarce resources, decision-making process, community support, assessment criteria, and promote the common good.

Breastfeeding Telephone Triage and Advice

2012 ◽  
Author(s):  
Maya Bunik
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Medical Staff ◽  
Telephone Triage ◽  
Triage Decision

New Edition! This all-new telehealth care resource helps nurses, lactation professionals, and other medical staff confidently advise breastfeeding mothers. The volume introduces more than 60 practice-tested breadstfeeding protocols. New Edition! This all-new telehealth care resource helps nurses, lactation professionals, and other medical staff confidently advise breastfeeding mothers. The volume introduces more than 60 practice-tested breadstfeeding protocols. Here’s how to respond when breastfeeding mothers call for help… Breastfeeding Telephone Triage and Advice Authored by Maya Bunik, MD, MSPH, FABM, FAAP This all-new decision support care tool helps nurses, lactation professionals, and other medical staff confidently advise breastfeeding mothers. Created by one of the field’s foremost authorities, it is designed to be used in tandem with the acclaimed AAP best seller Pediatric Telephone Protocols. This volume introduces 60 practice-tested protocols presented on easy-reading double-column pages to help simplify targeted triage decision-making.

Employing Exfoliated Graphite as Novel Support Material for Heterogeneous Model Catalysts

2019 ◽  
Author(s):  
Moritz Wolf ◽  
Nico Fischer ◽  
Michael Claeys
Keyword(s):  
Surface Area ◽  
Graphite Powder ◽  
Model Catalysts ◽  
Model Systems ◽  
Exfoliated Graphite ◽  
Support Material ◽  
Heterogeneous Model ◽  
Support Materials ◽  
Metal Support Interaction ◽  
Catalyst Systems

<p>The inert nature of graphitic samples allows for characterisation of rather isolated supported nanoparticles in model catalysts, as long as sufficiently large inter-particle distances are obtained. However, the low surface area of graphite and the little interaction with nanoparticles result in a challenging application of conventional preparation routes in practice. In the present study, a set of graphitic carbon materials was characterised in order to identify potential support materials for the preparation of model catalyst systems. Various sizes of well-defined Co<sub>3</sub>O<sub>4</sub> nanoparticles were synthesised separately and supported onto exfoliated graphite powder, that is graphite after solvent-assisted exfoliation <i>via</i> ultrasonication resulting in thinner flakes with increased specific surface area. The developed model catalysts are ideally suited for sintering studies of isolated nano-sized cobaltous particles as the graphitic support material does not provide distinct metal-support interaction. Furthermore, the differently sized cobaltous particles in the various model systems render possible studies on structural dependencies of activity, selectivity, and deactivation in cobalt oxide or cobalt catalysed reactions.</p>

Sistem Pendukung Keputusan SNMPTN Jalur Undangan Dengan Metode Electre

2018 ◽  
Vol 3 ◽  
pp. 14
Author(s):  
Lidia K Simanjuntak ◽  
Tessa Y M Sihite ◽  
Mesran Mesran ◽  
Nuning Kurniasih ◽  
Yuhandri Yuhandri
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Support System ◽  
Action Selection ◽  
Multi Criteria Decision Making ◽  
Prospective Students ◽  
College Entrance ◽  
Electre Method ◽  
Selection Of

All colleges each year organize the selection of new admissions. Acceptance of prospective students in universities as education providers is done by selecting prospective students based on achievement in school and college entrance selection. To select the best student candidates based on predetermined criteria, then use Multi-Criteria Decision Making (MCDM) or commonly called decision support system. One method in MCDM is the Elimination Et Choix Traduisant la Reality (ELECTRE). The ELECTRE method is the best method of action selection. The ELECTRE method to obtain the best alternative by eliminating alternative that do not fit the criteria and can be applied to the decision SNMPTN invitation path.

PEMILIHAN KEPLING TELADAN MENERAPKAN METODE RANK ORDER CENTROID (ROC) DAN METODE ADDITIVE RATIO ASSESSMENT (ARAS) DI KECAMATAN MEDAN AREA

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Liza Handayani ◽  
Muhammad Syahrizal ◽  
Kennedi Tampubolon
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Support System ◽  
Rank Order ◽  
Priority Level ◽  
The Village ◽  
Field Area ◽  
Selection Of

The head of the environment is an extension of the head of the village head in assisting or providing services to the community both in the administration of administration in the village and to other problems. It is natural for a kepling to be appreciated for their performance during their special tenure in the kecamatan field area. Previously, the selection of a dipling in a sub-district was very inefficient and seemed unfair for this exemplary selection to use a system to produce an accurate value, and no intentional element. To overcome the process of selecting an exemplary kepling that experiences these obstacles by using an application called a Decision Support System. Decision Support System (SPK) is a system that can solve a problem, and this system is also assisted with several methods, namely the Rank Order Centroid (ROC) method that can assign weight values to each of the criteria based on their priority level. And to do the ranking or determine an exemplary set using the Additive Ratio Assessment (ARAS) method, this method provides decision making that takes decisions based on ranking or the highest value.Keywords: Head of Medan Area Subdistrict, SPK, Centroid Rank Order, Additive Ratio Assessment (ARAS).

SISTEM PENDUKUNG KEPUTUSAN PEMILIHAN GURU BERPRESTASI KOTA MEDAN MENERAPKAN METODE PREFERENCES SELECTION INDEX (STUDI KASUS : DINAS PENDIDIKAN KOTA MEDAN)

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Fajar Syahputra ◽  
Mesran Mesran ◽  
Ikhwan Lubis ◽  
Agus Perdana Windarto
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Support System ◽  
Formal Education ◽  
Basic Education ◽  
Selection Index ◽  
Main Task ◽  
Selection Of

The teacher is a major milestone in the world of education, the ability and achievement of students cannot be separated from the role of a teacher in teaching and guiding students. Based on the Law of the Republic of Indonesia No. 14 of 2005 concerning Teachers and Lecturers, in Article 1 explained that teachers are professional educators with the main task of educating, teaching, guiding, directing, training, evaluating, and evaluating students in early childhood education through formal education, basic education and education medium. Whereas in Article 4 of the Act, it is explained that the position of teachers as professionals serves to enhance the dignity and role of teachers as learning agents to function to improve the quality of national education.Decision making is an election process, among various alternatives that aim to meet one or several targets. The decision-making system has 4 phases, namely intelligence, design, choice and implementation. These phases are the basis for decision making, which ends with a recommendation.The Preferences Selection Index (PSI) method is a rarely used decision support system method. This method is a method developed by stevanie and Bhatt (2010) to solve the Multi Criteria Decision Making (MCDM). With the right consideration, this method can be one of the tools to determine policies in decision-making systems, especially the selection of outstanding teachers. Determination of policies taken as a basis for decision making, must use criteria that can be defined clearly and objectively.Keywords: Decision Support System, PSI, Selection of Achieving Teachers

IMPLEMENTASI METODE VIKOR DALAM PENERIMAAN JURNALIS PADA KORAN WASPADA MEDAN

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Soraya Rahma Hayati ◽  
Mesran Mesran ◽  
Taronisokhi Zebua ◽  
Heri Nurdiyanto ◽  
Khasanah Khasanah
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Decision Support Systems ◽  
Support System ◽  
Support Systems ◽  
Knowledge Based ◽  
Computer Based ◽  
Support Decision Making ◽  
Made In

The reception of journalists at the Waspada Daily Medan always went through several rigorous selections before being determined to be accepted as journalists at the Waspada Medan Daily. There are several criteria that must be possessed by each participant as a condition for becoming a journalist in the Daily Alert Medan. To get the best participants, the Waspada Medan Daily needed a decision support system. Decision Support Systems (SPK) are part of computer-based information systems (including knowledge-based systems (knowledge management)) that are used to support decision making within an organization or company. Decision support systems provide a semitructured decision, where no one knows exactly how the decision should be made. In this study the authors applied the VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) as the method to be applied in the decision support system application. The VIKOR method is part of the Multi-Attibut Decision Making (MADM) Concept, which requires normalization in its calculations. The expected results in this study can obtain maximum decisions.Keywords: Journalist Acceptance, Decision Support System, VIKOR

The impact of patient narratives on medical students’ perceptions of shared decision making: A randomized controlled trial

2020 ◽  
Author(s):  
Martina Bientzle ◽  
Marie Eggeling ◽  
Simone Korger ◽  
Joachim Kimmerle
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Shared Decision Making ◽  
Medical Training ◽  
Controlled Trial ◽  
Future Research ◽  
Shared Decision ◽  
Randomized Controlled ◽  
Information Text ◽  
The Impact

BACKGROUND: Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students.METHODS: In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative patient testimonial or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation.RESULTS: Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with more than one treatment option to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation.CONCLUSIONS: These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research.

Models of decision support in socio-cyber-physical systems

2019 ◽  
pp. 55-70 ◽  
Author(s):  
A. V. Smirnov ◽  
T. V. Levashova
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Situation Awareness ◽  
Cyber Physical Systems ◽  
Emergent Behavior ◽  
Emergent Properties ◽  
Decision Making Process ◽  
Physical Systems ◽  
Decision Support Models ◽  
Common Goals

Introduction: Socio-cyber-physical systems are complex non-linear systems. Such systems display emergent properties. Involvement of humans, as a part of these systems, in the decision-making process contributes to overcoming the consequences of the emergent system behavior, since people can use their experience and intuition, not just the programmed rules and procedures.Purpose: Development of models for decision support in socio-cyber-physical systems.Results: A scheme of decision making in socio-cyber-physical systems, a conceptual framework of decision support in these systems, and stepwise decision support models have been developed. The decision-making scheme is that cybernetic components make their decisions first, and if they cannot do this, they ask humans for help. The stepwise models support the decisions made by components of socio-cyber-physical systems at the conventional stages of the decision-making process: situation awareness, problem identification, development of alternatives, choice of a preferred alternative, and decision implementation. The application of the developed models is illustrated through a scenario for planning the execution of a common task for robots.Practical relevance: The developed models enable you to design plans on solving tasks common for system components or on achievement of common goals, and to implement these plans. The models contribute to overcoming the consequences of the emergent behavior of socio-cyber-physical systems, and to the research on machine learning and mobile robot control.

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