The Role Tabletop Exercise Using START in Improving Triage Ability in Disaster Medical Assistance Team

Triage ability is a critical skill the members of a disaster medical assistance team (DMAT) should possess. There are few data concerning the triage accuracy in the pre-hospital providers and the members of DMAT. We thus conducted a lecture-based intervention and evaluated the impact of the triage method using a written multiple-casualty incident (MCI) scenario. We enrolled and tested 30 volunteers in a local DMAT training program. The written scenario of a MCI consisted of 40 victims with 5 first priority patients, 17 second priority patients, and 18 third priority patients. The scenario was tested in the volunteers before and immediately after a one-hour lecture of Simple Triage and Rapid Treatment (START) with slide presentation. The mean immediate post-intervention score (87.8% correct) was significantly improved compared with the mean pre-intervention score (55.8% correct) for the 30 volunteers (P<0.001). The over-triage rate was significantly reduced before (28.6%) and immediate after (1%) the intervention (P<0.001). The under-triage rate was also reduced from 15.5% to 11.2% (P<0.05). Tabletop exercises have several advantages over field operation drills. Using tabletop exercise can simulate the disaster or major incidents and evaluate critical knowledge and skills. The training model using START method in a tabletop exercise could significantly improve the triage ability and reduce overtriage and undertriage rate. (Ann Disaster Med. 2003;1:78-84)