The effect of training and experience on mass casualty incident triage performance: Evidence from emergency personnel in a high complexity university hospital

2019 ◽  
Vol 14 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Juan P. Vargas, MD, MSc ◽  
Ives Hubloue, MD, PhD ◽  
Jazmín J. Pinzón, MD ◽  
Alejandra Caycedo Duque, MD
Keyword(s):  
Emergency Department ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
University Hospital ◽  
Trauma Patients ◽  
Post Intervention ◽  
Cross Sectional ◽  
Emergency Department Staff ◽  
Department Staff ◽  
Before And After

Mass casualty incident (MCI) can occur at any time and place and health care institutions must be prepared to deal with these incidents. Emergency department staff rarely learn how to triage MCI patients during their medical or nurse degrees, or through on-the-job training. This study aims to evaluate the effect of training and experience on the MCI triage performance of emergency personnel.Methodology: This was a cross-sectional prospective study that analyzed the performance of 94 emergency department staff on the triage classifications of 50 trauma patients, before and after a short training in MCI triage, while taking into account their academic background and work experience.Results: The participants were assigned initially to one of two groups: low experience if they had less than 5 years of practice, and high experience if they had more than 5 years of practice. In the low experience group, the initial accuracy was 45.76 percent, over triage 45.84 percent, and subtriage 8.38 percent. In the high experience group, the initial accuracy was 53.80 percent, over triage 37.66 percent, and sub triage 8.57 percent.Postintervention Results: In the low experience group, the post intervention accuracy was 63.57 percent, over triage 21.15 percent, and subtriage 15.30 percentage. In the high experience group, the post-intervention accuracy was 67.66 percentage, over triage 15.19 percentage, and subtriage 17.14 percentage.  Conclusion: Upon completion of this study, it can be concluded that MCI triage training significantly improved the performance of all those involved in the workshop and that experience plays an important role in MCI triage performance.

scholarly journals Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident

2014 ◽  
Vol 29 (5) ◽  
pp. 538-541 ◽  
Author(s):  
Benjamin W. Wachira ◽  
Ramadhani O. Abdalla ◽  
Lee A. Wallis
Keyword(s):  
Emergency Department ◽  
Emergency Preparedness ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
University Hospital ◽  
Shopping Mall ◽  
Major Incident ◽  
Local Health ◽  
Publication Type ◽  
Communication Assessment

AbstractAt approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital.This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.WachiraBW, AbdallaRO, WallisLA. Westgate shootings: an emergency department approach to a mass-casualty incident. Prehosp Disaster Med. 2014;29(5):1-4.

scholarly journals MP05: Do emergency department staff use a current domestic violence documentation tool or other forms of intimate partner violence documentation in patient records?

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S66 ◽  
Author(s):  
J. Vonkeman ◽  
P.R. Atkinson ◽  
J. Fraser ◽  
R. McCloskey
Keyword(s):  
Emergency Department ◽  
Domestic Violence ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Online Survey ◽  
Intimate Partner ◽  
Cross Sectional ◽  
Emergency Department Staff ◽  
Department Staff ◽  
Documentation Tool

Introduction: Domestic violence (DV) rates in smaller cities been reported to be some of the highest in Canada. It is highly likely that emergency department staff will come across victims of intimate partner violence (IPV) in their daily practice. The purpose of this study is to better understand current practices for detecting IPV as we are currently uncertain whether patients are assessed for IPV and what the current documentation practices are. Methods: A standardized retrospective chart review, following principles outlined by Gilbert et al. 1996, was completed by two researchers to capture domestic violence documentation rates in patients presenting to the ED between January and April 2015 with injuries that may have been caused by IPV. To assess self-reported documentation/questioning practices, a cross-sectional online survey was distributed to ED staff via staff email lists three times between July and October 2016, with a response rate of 45.9% (n=55). The primary outcome was DV field usage. Secondary outcomes included documentation in patient charts and current questioning habits. Results: Overall, we found documentation in 4.64% of all included patient charts (n=366). No documentation was noted in the DV field. 52.4% patients with deliberate injuries had no documentation of assailant identity. With regards to self reported documentation practices, 16.4% of ED staff never questioned female patients about intimate partner violence, 83.6% asked when thought appropriate, and none asked routinely. None of the staff used a structured screening tool. 60% of ED staff documented their questioning but 92.7% did not use the DV-field for documentation. 58.2% of ED staff could not identify the DV field and 45.5% of respondents did not know how to interpret the DV field if positive. Conclusion: Our findings suggest that the current documentation tool (DV-field) is not being utilized. Furthermore, low rates of IPV documentation, and potentially questioning, in high risk patients indicates that there is need to improve current practises.

Emergency Department Staff Preparedness for Mass Casualty Events Involving Children

2007 ◽  
Vol 5 (2) ◽  
pp. 36-44 ◽  
Author(s):  
Michal Rassin ◽  
Miri Avraham ◽  
Anat Nasi-Bashari ◽  
Sigalit Idelman ◽  
Yaniv Peretz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Mass Casualty ◽  
Emergency Department Staff ◽  
Department Staff ◽  
Mass Casualty Events

Quality Improvement to Decrease Specimen Mislabeling in Transfusion Medicine

2006 ◽  
Vol 130 (8) ◽  
pp. 1196-1198 ◽  
Author(s):  
Karen Quillen ◽  
Kate Murphy
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Data Collection ◽  
Historical Record ◽  
University Hospital ◽  
Transfusion Medicine ◽  
Emergency Department Staff ◽  
Department Staff ◽  
Timely Feedback ◽  
Specimen Identification

Abstract Context.—Proper specimen identification and labeling is a critical preanalytic step in pretransfusion compatibility testing. Objective.—To gather baseline data for specimen mislabeling, specifically targeting major mislabeling events, and to design and implement a plan of corrective action. Design.—All mislabeled specimens received by the transfusion service for a type and screen were recorded and classified into minor and major mislabeling categories. Major mislabeling events were tracked by origin of the specimen. Locations with a high proportion of major mislabeling were given timely feedback (within 1 week) of the events as they arose. Setting.—A university hospital. Main Outcome Measures.—The incidence of major mislabeling. Results.—The incidence of mislabeling in the transfusion service was 0.5% (243/49 955) during 21 months of data collection. Of these mislabeling events, 47% were classified as major events (unlabeled, mismatched specimen/ requisition, ABO/Rh result on current specimen not matching historical record on file). The emergency department accounted for a high proportion of these major mislabeling events. After the intervention of providing weekly feedback to emergency department staff, their contribution to major mislabeling fell from 47% in 1 year (23/49) to 14% (4/29) in the subsequent 3 quarters. Conclusions.—Collecting and trending data on mislabeled samples with timely feedback to patient care areas can change phlebotomy practice and reduce specimen mislabeling.

scholarly journals Comparison of the Effects of Sacco and START Triage Methods in the Death Risk Assessment of Mass Trauma Patients after Earthquake

2019 ◽  
Vol 34 (s1) ◽  
pp. s109-s110
Author(s):  
Wang Aoyu ◽  
Lin Run ◽  
Chen Yaqi ◽  
Tao Mengjiao ◽  
Hu Hai
Keyword(s):  
Risk Assessment ◽  
Emergency Department ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Trauma Patients ◽  
Receiver Operator Curve ◽  
Mass Trauma ◽  
Death Risk ◽  
The One ◽  
Operator Curve

Introduction:Compared with traditional START Triage Method, the Sacco Triage Method is a new way to access death risk in disaster scenes. However, due to the difficulties in disaster medical research, there is still no evidence to prove which one is more effective.Aim:To assess and compare the value of START Triage Method and Sacco Triage Method in the death risk assessment of transport and the one-month death risk assessment of the earthquake mass trauma patients.Methods:A retrospective analysis was conducted on 1,612 patients who were transferred to the West China Hospital by assigning to different triage levels by Sacco Triage Method and START Triage Method respectively. Both of the triage methods were evaluated based on death cases on either during transport or in the emergency department, using the area under the receiver-operator curve.Results:For death during the transport and in the emergency department, the receiver-operator curve of two groups reflected as 0.721 and 0.649. For death in a consequence, the receiver-operator curve of the two groups was revealed as 0.667 and 0.519.Discussion:As an accurate triage method, the Sacco Triage Method may be used in a mass casualty incident. It is a more effective way than the START Triage Method for the evaluation of death risk assessment of the mass trauma patients.

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