Primary mass casualty incident triage: evidence for the benefit of yearly brief re-training from a simulation study.
TL;DR: To improve disaster preparedness, triage skills should be refreshed yearly by a brief re-education of all EMS providers.
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Abstract: Triage is a mainstay of early mass casualty incident (MCI) management. Standardized triage protocols aim at providing valid and reproducible results and, thus, improve triage quality. To date, there is little data supporting the extent and content of training and re-training on using such triage protocols within the Emergency Medical Services (EMS). The study objective was to assess the decline in triage skills indicating a minimum time interval for re-training. In addition, the effect of a one-hour repeating lesson on triage quality was analyzed. A dummy based trial on primary MCI triage with yearly follow-up after initial training using the ASAV algorithm (Amberg-Schwandorf Algorithm for Primary Triage) was undertaken. Triage was assessed concerning accuracy, sensitivity, specificity, over-triage, under-triage, time requirement, and a comprehensive performance measure. A subgroup analysis of professional paramedics was made. Nine hundred ninety triage procedures performed by 51 providers were analyzed. At 1 year after initial training, triage accuracy and overall performance dropped significantly. Professional paramedic’s rate of correctly assigned triage categories deteriorated from 84 to 71%, and the overall performance score decreased from 95 to 90 points (maximum = 100). The observed decline in triage performance at 1 year after education made it necessary to conduct re-training. A brief didactic lecture of 45 min duration increased accuracy to 88% and the overall performance measure to 97. To improve disaster preparedness, triage skills should be refreshed yearly by a brief re-education of all EMS providers.
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TL;DR: In this paper, a search based on the PRISMA guidelines for scoping reviews was conducted to retrieve articles in the following databases: Medline, PsychInfo and Scopus, and the searches were limited to English, French, Dutch and German language articles.
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EMS, Mass Casualty Triage
Leigha Clarkson,Mollie Williams +1 more
- 25 Feb 2019
TL;DR: The World Health Organization defines mass casualty incidents as disasters and major incidents characterized by quantity, severity, and diversity of patients that can rapidly overwhelm the ability of local medical resources to deliver comprehensive and definitive medical care as discussed by the authors.
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Perspectives of Triage Team Members Participating in Statewide Triage Simulations for Scarce Resource Allocation During the COVID-19 Pandemic in Washington State
Catherine R. Butler,Laura B. Webster,Douglas S. Diekema,Megan M. Gray,Vicki L. Sakata,Mark R. Tonelli,Kelly C. Vranas +6 more
TL;DR: There were challenges in adapting clinical intuition and training to a distinctive role in the process of scarce resource allocation and the findings suggest that clinical experience, education in ethical and operational foundations of triage, and experiential training, such as triage simulations, may help prepare clinicians for this difficult role.
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TL;DR: The Medical Disaster Response project deals with the scenario in which specially trained, local health-care providers evaluate patients immediately after the event, but cannot evacuate patients to definitive care, which is the first systematic attempt to use triage as a tool to maximize patient benefit in the immediate aftermath of a catastrophic disaster.
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Comparative analysis of multiple-casualty incident triage algorithms.
TL;DR: Of the physiologic variables used in the triage algorithms, the Motor Component of the Glasgow Coma Scale and systolic blood pressure had the strongest association with severe injury.
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Mass casualty triage: an evaluation of the data and development of a proposed national guideline.
E. Brooke Lerner,Richard B. Schwartz,Phillip L. Coule,Eric S. Weinstein,David C. Cone,Richard C. Hunt,Scott M. Sasser,J. Marc Liu,Nikiah G. Nudell,Ian S. Wedmore,Jeffrey S. Hammond,Eileen M. Bulger,Jeffrey P. Salomone,Teri L. Sanddal,Graydon Lord,David Markenson,Robert E. O'Connor +16 more
TL;DR: The proposed guideline, entitled SALT (sort, assess, life-saving interventions, treatment and/or transport) triage, was developed based on the best available science and consensus opinion and incorporates aspects from all of the existing triage systems to create a single overarching guide for unifying the mass casualty triage process across the United States.
Mass casualty triage: an evaluation of the science and refinement of a national guideline.
E. Brooke Lerner,David C. Cone,Eric S. Weinstein,Richard B. Schwartz,Phillip L. Coule,Michael Cronin,Ian S. Wedmore,Eileen M. Bulger,Deborah Ann Mulligan,Raymond E. Swienton,Scott M. Sasser,Umair A. Shah,Leonard J. Weireter,Teri L. Sanddal,Julio Lairet,David Markenson,Lou E Romig,Gregg Lord,Jeffrey P. Salomone,Robert E. O'Connor,Richard C. Hunt +20 more
TL;DR: The Model Uniform Core Criteria for Mass Casualty Triage were developed to be a national guideline for mass casualty triage to ensure interoperability and standardization when responding to a mass casualty incident.
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Validierung der Vorsichtung nach dem mSTaRT-Algorithmus
April O. Paul,M. V. Kay,T. Huppertz,F. Mair,Y. Dierking,P. Hornburger,Wolf Mutschler,K.-G. Kanz +7 more
TL;DR: In this paper, a modified simple triage and rapid treatment (mSTaRT) algorithm was used to sort the patients in a massenanfall of Verletzten.
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