Implementing RFID technology in a novel triage system during a simulated mass casualty situation

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.

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The SALT and START Triage System for Classifying Patient Acuity Level: A Systematic Review

Nurse Media Journal of Nursing ◽

10.14710/nmjn.v11i3.37008 ◽

2021 ◽

Vol 11 (3) ◽

pp. 413-427

Author(s):

Hendri Purwadi ◽

Katrina Breaden ◽

Christine McCloud ◽

Satriya Pranata

Keyword(s):

Systematic Review ◽

Grey Literature ◽

Mass Casualty ◽

Patient Acuity ◽

Triage System ◽

Wide Range ◽

Simulation Based ◽

System 2 ◽

Triage Algorithm

Background: Two common triage systems have been widely used in mass casualty incidents (MCIs) and disaster situations, namely START (simple triage algorithm and rapid treatment) and SALT (sort, assess, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over the START triage system.Purpose: This systematic review aims to compare the accuracy of the SALT and START triage systems in disaster and MCI settings.Methods: The literature was searched using a systematic search strategy for articles published from 2009 to 2020 in the Medline, CINAHL, Web of Science, Scopus, PubMed, ProQuest databases, and the grey literature. This review included simulation-based and medical record-based studies investigating the accuracy and applicability of the SALT and START triage systems in adult and child populations during MCIs and disasters. All types of studies were included. The PRISMA flowchart was used to retain the articles, and the Joanna Briggs Institute critical appraisal tools were used to assess the quality of the reviewed studies.Results: Of 1,450 articles identified in the search, 10 articles were included. It was found that the START triage system had a wide range and inconsistent levels of accuracy (44% to 94.2%) compared to the SALT triage system (70% to 83%). The under-triage error of the START triage system ranged from 2.73% to 20%, which was slightly lower than the SALT triage system (7.6% to 23.3%). The over-triage error of the START triage system (2% to 53%) was slightly higher than the SALT triage system (2% to 22%). However, the time taken to apply START triage system (70 to 72.18 seconds) was faster than for the SALT triage system (78 seconds).Conclusion: The START triage system was simpler and faster than SALT. Conversely, the SALT triage system appeared to be slightly more accurate, more consistent, and had a lower rate of under- and over-triage error than START. It appears that neither the SALT nor the START triage system is superior to the other. Further research is needed to establish the most appropriate disaster and MCI triage system, especially for the Indonesian context.

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Development of the Aerial Remote Triage System: Result of a survey of international experts

10.1101/2020.11.13.20230979 ◽

2020 ◽

Author(s):

Cristina Álvarez-García ◽

Sixto Cámara-Anguita ◽

José María López-Hens ◽

Nani Granero-Moya ◽

María Dolores López-Franco ◽

...

Keyword(s):

Literature Review ◽

Major Bleeding ◽

Content Validity ◽

Mass Casualty ◽

Qualitative Synthesis ◽

Triage System ◽

Physical Chemical ◽

Three Stages ◽

International Experts ◽

Triage Algorithm

AbstractThe use of drones for the triage of victims in mass-casualty incidents has recently emerged as a promising technology. However, there is not a triage system really adapted to a remote usage. The objective of our study was to develop a remote triage procedure using drones. The research was performed in three stages: literature review, development of a remote triage algorithm using drones and evaluation of the algorithm by experts. A qualitative synthesis and the calculation of content validity ratios were done to achieve the Aerial Remote Triage System. The system assesses first major bleeding, second walking, third conscious (awake) and fourth sign of life; and classify the victims inside priority categories: priority 1 (red), priority 2 (yellow), priority 3 (green) and priority * (violet). It includes the possibility to indicate save-living interventions to victims and bystanders, like the compression of bleeding injuries or the recovery position. The Aerial Remote Triage System is valid in complex health emergencies when it is difficult or impossible an immediate access to the scene due to physical, chemical or biological risks. It can be useful to know vital information about the emergencies.

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Model Uniform Core Criteria for Mass Casualty Triage

Disaster Medicine and Public Health Preparedness ◽

10.1001/dmp.2011.41 ◽

2011 ◽

Vol 5 (2) ◽

pp. 125-128 ◽

Cited By ~ 20

Keyword(s):

Public Health ◽

Scientific Evidence ◽

Geographic Location ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Expert Consensus ◽

Research Gaps ◽

Triage System ◽

Significant Research ◽

Primary Triage

ABSTRACTThere is a need for model uniform core criteria for mass casualty triage because disasters frequently cross jurisdictional lines and involve responders from multiple agencies who may be using different triage tools. These criteria (Tables 1-4) reflect the available science, but it is acknowledged that there are significant research gaps. When no science was available, decisions were formed by expert consensus derived from the available triage systems. The intent is to ensure that providers at a mass-casualty incident use triage methodologies that incorporate these core principles in an effort to promote interoperability and standardization. At a minimum, each triage system must incorporate the criteria that are listed below. Mass casualty triage systems in use can be modified using these criteria to ensure interoperability. The criteria include general considerations, global sorting, lifesaving interventions, and assignment of triage categories. The criteria apply only to providers who are organizing multiple victims in a discrete geographic location or locations, regardless of the size of the incident. They are classified by whether they were derived through available direct scientific evidence, indirect scientific evidence, expert consensus, and/or are used in multiple existing triage systems. These criteria address only primary triage and do not consider secondary triage. For the purposes of this document the term triage refers to mass-casualty triage and provider refers to any person who assigns primary triage categories to victims of a mass-casualty incident.(Disaster Med Public Health Preparedness. 2011;5:125–128)

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AN AUSTRALIAN MASS CASUALTY INCIDENT TRIAGE SYSTEM FOR THE FUTURE BASED UPON TRIAGE MISTAKES OF THE PAST: THE HOMEBUSH TRIAGE STANDARD

ANZ Journal of Surgery ◽

10.1046/j.1440-1622.1999.01644.x ◽

1999 ◽

Vol 69 (8) ◽

pp. 603-608 ◽

Cited By ~ 41

Author(s):

Antony Nocera ◽

Alan Garner

Keyword(s):

Mass Casualty Incident ◽

Mass Casualty ◽

Triage System ◽

The Past ◽

The Future

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FAST Ultrasound as an Adjunct to Triage Using the START Mass Casualty Triage System:

Prehospital Emergency Care ◽

10.1080/10903120500373058 ◽

2006 ◽

Vol 10 (1) ◽

pp. 96-102 ◽

Cited By ~ 23

Author(s):

Matthew D. Sztajnkrycer ◽

Amado Alejandro Baez ◽

Anuradha Luke

Keyword(s):

Mass Casualty ◽

Triage System

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EMS Response to an Airliner Crash

Prehospital and Disaster Medicine ◽

10.1017/s1049023x12000854 ◽

2012 ◽

Vol 27 (3) ◽

pp. 299-302 ◽

Cited By ~ 2

Author(s):

Shuvra Dasgupta ◽

Simone French ◽

Jean Williams-Johnson ◽

Rhonda Hutson ◽

Nicole Hart ◽

...

Keyword(s):

Case Report ◽

Public Education ◽

Emergency Medical Services ◽

First Responders ◽

Mass Casualty ◽

Triage System ◽

Mass Casualty Event ◽

Personnel Practice ◽

Simulation Exercises ◽

Aircraft Crash

AbstractThis report of an aircraft crash at a major airport in Kingston, Jamaica examines the response of the local Emergency Medical Services (EMS). Factors that impacted the response are discussed, and the need for more disaster simulation exercises is highlighted. The objective of this case report was to document the response of EMS personnel to the crash of American Airlines Flight 331, and to utilize the information to examine and improve the present protocol.While multiple errors can occur during a mass-casualty event, these can be reduced by frequent simulation exercises during which various personnel practice and learn designated roles. Efficient triage, proper communication, and knowledge of the roles are important in ensuring the best possible outcome. While the triage system and response of the EMS personnel were effective for this magnitude of catastrophe, more work is needed in order to meet predetermined standards. Ways in which this can be overcome include: (1) hosting more disaster simulation exercises; (2) encouraging more involvement with first responders; and (3) strengthening the links in the local EMS system. Vigorous public education must be instituted and maintained.Dasgupta S, French S, Williams-Johnson J, Hutson R, Hart N, Wong M, Williams E, Espinosa K, Maycock C, Edwards R, McCartney T, Cawich S, Crandon I. EMS response to an airliner crash. Prehosp Disaster Med. 2012;27(3):1-4.

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Development of the Aerial Remote Triage System using drones in mass casualty scenarios: A survey of international experts

PLoS ONE ◽

10.1371/journal.pone.0242947 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0242947

Author(s):

Cristina Álvarez-García ◽

Sixto Cámara-Anguita ◽

José María López-Hens ◽

Nani Granero-Moya ◽

María Dolores López-Franco ◽

...

Keyword(s):

Literature Review ◽

Major Bleeding ◽

Mass Casualty ◽

Qualitative Synthesis ◽

Triage System ◽

Complex Emergencies ◽

Physical Chemical ◽

Three Stages ◽

International Experts ◽

Triage Algorithm

The use of drones for triage in mass-casualty incidents has recently emerged as a promising technology. However, there is no triage system specifically adapted to a remote usage. Our study aimed to develop a remote triage procedure using drones. The research was performed in three stages: literature review, the development of a remote triage algorithm using drones and evaluation of the algorithm by experts. Qualitative synthesis and the calculation of content validity ratios were done to achieve the Aerial Remote Triage System. This algorithm assesses (in this order): major bleeding, walking, consciousness and signs of life; and then classify the injured people into several priority categories: priority 1 (red), priority 2 (yellow), priority 3 (green) and priority * (violet). It includes the possibility to indicate save-living interventions to injured people and bystanders, like the compression of bleeding injuries or the adoption of the recovery position. The Aerial Remote Triage System may be a useful way to perform triage by drone in complex emergencies when it is difficult to access to the scene due to physical, chemical or biological risks.

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