A concept for major incident triage: full-scaled simulation feasibility study.
Summary of "A concept for major incident triage: full-scaled simulation feasibility study."
ABSTRACT:
BACKGROUND:
Efficient management of major incidents involves triage, treatment and transport. In the absence of a standardised interdisciplinary major incident management approach, the Norwegian Air Ambulance Foundation developed Interdisciplinary Emergency Service Cooperation Course (TAS). The TAS-program was established in 1998 and by 2009, approximately 15 500 emergency service professionals have participated in one of more than 500 no-cost courses. The TAS-triage concept is based on the established triage Sieve and Paediatric Triage Tape models but modified with slap-wrap reflective triage tags and paediatric triage stretchers. We evaluated the feasibility and accuracy of the TAS-triage concept in full-scale simulated major incidents.
METHODS:
The learners participated in two standardised bus crash simulations: without and with competence of TAS-triage and access to TAS-triage equipment. The instructors calculated triage accuracy and measured time consumption while the learners participated in a self-reported before-after study. Each question was scored on a 7-point Likert scale with points labelled "Did not work" (1) through "Worked excellent" (7).
RESULTS:
Among the 93 (85%) participating emergency service professionals, 48% confirmed the existence of a major incident triage system in their service, whereas 27% had access to triage tags. The simulations without TAS-triage resulted in a mean over- and undertriage of 12%. When TAS-Triage was used, no mistriage was found. The average time from "scene secured to all patients triaged" was 22 minutes (range 15-32) without TAS-triage vs. 10 minutes (range 5-21) with TAS-triage. The participants replied to "How did interdisciplinary cooperation of triage work?" with mean 4,9 (95% CI 4,7-5,2) before the course vs. mean 5,8 (95% CI 5,6-6,0) after the course, p<0,001.
CONCLUSIONS:
Our modified triage Sieve tool is feasible, time-efficient and accurate in allocating priority during simulated bus accidents and may serve as a candidate for a future national standard for major incident triage.
Affiliation
Journal Details
This article was published in the following journal.
Name: BMC emergency medicine
ISSN: 1471-227X
Pages: 17
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20701802
- DOI: http://dx.doi.org/10.1186/1471-227X-10-17
Medical and Biotech [MESH] Definitions
Semantic Differential
Analysis of word concepts by the association of polar adjectives, e.g., good-bad, with the concept, father. The adjectives are usually scaled in 7 steps. The subject's placement of the concept on the adjectival scale indicates the connotative meaning of the concept.
Molecular Dynamics Simulation
A computer simulation developed to study the motion of molecules over a period of time.
Triage
The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment.
Feasibility Studies
Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.
After-hours Care
Medical care provided after the regular practice schedule of the physicians. Usually it is designed to deliver 24-hour-a-day and 365-day-a-year patient care coverage for emergencies, triage, pediatric care, or hospice care.
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