A need for prehospital triage standardizing tool in mass casualty incidents

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.

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

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-021-00932-z ◽

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.

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

Healthcare ◽

10.3390/healthcare9070877 ◽

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.

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Prehospital triage for mass casualty incidents using the META method for early surgical assessment: retrospective validation of a hospital trauma registry

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-018-1040-6 ◽

2018 ◽

Vol 46 (2) ◽

pp. 425-433 ◽

Cited By ~ 1

Author(s):

Rodolfo Romero Pareja ◽

Rafael Castro Delgado ◽

Fernando Turégano Fuentes ◽

Israel Jhon Thissard-Vasallo ◽

David Sanz Rosa ◽

...

Keyword(s):

Trauma Registry ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Prehospital Triage

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Prehospital triage and communication performance in small mass casualty incidents: A gauge for disaster preparedness

The American Journal of Emergency Medicine ◽

10.1016/s0735-6757(99)90048-7 ◽

1999 ◽

Vol 17 (2) ◽

pp. 148-150 ◽

Cited By ~ 20

Author(s):

Gary A Johnson ◽

Anne Calkins

Keyword(s):

Disaster Preparedness ◽

Small Mass ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Communication Performance ◽

Prehospital Triage

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A call for collective learning from mass casualty incidents

Injury ◽

10.1016/j.injury.2021.02.068 ◽

2021 ◽

Author(s):

Amila Ratnayake ◽

Sanjeewa Garusinghe ◽

Miklosh Bala ◽

Tamara J. Worlton

Keyword(s):

Mass Casualty ◽

Collective Learning ◽

Mass Casualty Incidents

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Does Self-reporting Facilitate History Taking in Food Poisoning Mass-casualty Incidents?

Prehospital and Disaster Medicine ◽

10.1017/s1049023x14000764 ◽

2014 ◽

Vol 29 (4) ◽

pp. 417-420 ◽

Cited By ~ 1

Author(s):

Ya-I Hsu ◽

Ying C. Huang

Keyword(s):

Health Care ◽

Medical History ◽

Food Poisoning ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Control Group ◽

History Taking ◽

Care Providers ◽

Time Required ◽

Experimental Group

AbstractIntroductionMedical history is an important contributor to diagnosis and patient management. In mass-casualty incidents (MCIs), health care providers are often overwhelmed by large numbers of casualties. An efficient, reliable, and affordable method of information collection is essential for effective health care response.Hypothesis/ProblemIn some MCIs, self-reporting of symptoms can decrease the time required for history taking, without sacrificing the completeness of triage information.MethodsTwo resident doctors and a number of seventh graders who had previous experience of abdominal discomfort were invited to join this study. A questionnaire was developed to collect information on common symptoms in food poisoning. Each question was scored, and enrolled students were randomly divided into two groups. The experimental group students answered the questionnaire first and then were interviewed to complete the medical history. The control group students were interviewed in the traditional way to collect medical history. Time of all interviews was measured and recorded. The time needed to complete the history taking and completeness of obtained information were compared with students’ t tests, or Mann-Whitney U tests, based on the normality of data. Comprehensibility of each question, scored by enrolled students, was reported by descriptive statistics.ResultsThere were 41 students enrolled: 22 in the experimental group and 19 in the control group. Time to complete history taking in the experimental group (163.0 seconds, SD=52.3) was shorter than that in the control group (198.7 seconds, SD=40.9) (P=.010). There was no difference in the completeness of history obtained between the experimental group and the control group (94.8%, SD=5.0 vs 94.2%, SD=6.1; P=.747). Between the two doctors, no significant difference was found in the time required for history taking (185.2 seconds, SD=42.2 vs 173.1 seconds, SD=58.6; P=.449), or the completeness of information (94.1%, SD=5.9 vs 95.0%, SD=5.0; P=.601). Most of the questions were scored “good” in comprehensibility.ConclusionSelf-reporting of symptoms can shorten the time of history taking during a food poisoning mass-casualty event without sacrificing the completeness of information.HsuY, HuangYC. Does self-reporting facilitate history taking in food poisoning mass-casualty incidents?Prehosp Disaster Med. 2014;29(4):1-4.

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An internet-based bar code tracking system: coordination of confusion at mass casualty incidents

Disaster Management & Response ◽

10.1016/s1540-2487(03)70007-8 ◽

2003 ◽

Vol 1 (1) ◽

pp. 25-28 ◽

Cited By ~ 11

Author(s):

Jeff Hamilton

Keyword(s):

Tracking System ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Bar Code ◽

Code Tracking

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Using Baseline Data to Address the Lack of Hospital Beds during Mass-Casualty Incidents

Prehospital and Disaster Medicine ◽

10.1017/s1049023x0000604x ◽

2008 ◽

Vol 23 (4) ◽

pp. 377-379 ◽

Cited By ~ 1

Author(s):

Hysham Hadef ◽

Jean-Claude Bartier ◽

Herve Delplancq ◽

Jean-Pierre Dupeyron

Keyword(s):

Medical Personnel ◽

Mass Casualty ◽

Baseline Data ◽

Mass Casualty Incidents ◽

Free Access ◽

Data Systems ◽

Hospital Beds ◽

Access Information ◽

Data Program ◽

Information Database

AbstractThe management of victims during mass-casualty incidents (MCIs) is improving. In many countries, physicians and paramedics are well-trained to manage these incidents. A problem that has been encountered during MCIs is the lack of adequate numbers of hospital beds to accommodate the injured. In Europe, hospitals are crowded. One solution for the lack of beds is the creation of baseline data systems that could be consulted by medical personnel in all European countries. A MCI never has occurred in northeastern Europe, but such an event remains a possibility. This paper describes how the use of SAGEC 67, a free-access, information database concerning the availability of beds should help the participating countries, initially France, Germany, and Switzerland, respond to a MCI by dispatching each patient to an appropriate hospital and informing their families and physicians using their own language.Baseline data for more than 20 countries, and for hospitals, especially those in Germany, Switzerland, and France, were collected. Information about the number of beds and their availability hour-by-hour was included. In the case of MCIs, the baseline data program is opened and automatically connects to all of the countries. In case of a necessary hospital evacuation, the required beds immediately are occupied in one of these three countries.Questions and conversations among medical staff or family members can be accomplished between hospitals through computer, secured-line chatting that automatically translates into appropriate language.During the patient evacuation phase of a MCI, respondents acknowledged that a combination of local, state, and private resources and international cooperation eventually would be needed to meet the demand. Patient evacuation is optimized through the use of SAGEC 67, a free baseline database.

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