Effectiveness of and Adherence to Triage Algorithms during Prehospital Response to Mass Casualty Incidents
نویسندگان
چکیده
Introduction: At mass casualty incidents (MCIs) medical needs exceed available resources, requiring prioritization of response efforts and materials. Principles triage have evolved since the 18th century into several modern-day algorithms that sort casualties priority groups based on clinical parameters. It is unclear, however, if such are effective practical during real-world MCIs. This analysis reviews literature use efficacy prehospital MCI algorithms. Method: The MEDLINE, Scopus, Google Scholar databases were searched for peer-reviewed grey response. Articles discussing concepts, at MCIs, or algorithm included. excluded they described law enforcement, ethical, psychological epidemiological perspectives without detailing Results: Frequently-cited include START (Simple Triage & Rapid Treatment); Sieve; CareFlight; SALT (Sort, Assess, Lifesaving Interventions, Treatment/Transport); RAMP (Rapid Assessment Mentation Pulse). They differ in physiologic parameters assessed, inclusion numerical measurements, number categories. Surveyed providers less likely to performed full MCIs (16%) than training (69%), more no (29% vs. 1%). In retrospective trauma registry analyses, generally poorly predictive need life-saving interventions (13-58% sensitive, 72-97% specific) one study, variably critical injury (45-85% 86-96% another. Glasgow Coma Scale motor component was associated with (73% 96% specific <6); other variables had sensitivities under 40%. prospective studies, accurate 36-52% adults 56-59% children. Some suggest clinician judgment may be similarly effective. Conclusion: Multiple exist triage, but infrequently utilized inaccurate. Simpler, realistic, scalable, widely accepted systems instituted.
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ژورنال
عنوان ژورنال: Prehospital and Disaster Medicine
سال: 2023
ISSN: ['1049-023X', '1945-1938']
DOI: https://doi.org/10.1017/s1049023x23004788