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dc.contributor.authorHart, Alexander
dc.contributor.authorNammour, Elias
dc.contributor.authorMangolds, Virginia B.
dc.contributor.authorBroach, John
dc.date2022-08-11T08:08:17.000
dc.date.accessioned2022-08-23T15:49:37Z
dc.date.available2022-08-23T15:49:37Z
dc.date.issued2018-08-01
dc.date.submitted2018-12-05
dc.identifier.citation<p>Prehosp Disaster Med. 2018 Aug;33(4):355-361. doi: 10.1017/S1049023X18000626. <a href="https://doi.org/10.1017/S1049023X18000626">Link to article on publisher's site</a></p>
dc.identifier.issn1049-023X (Linking)
dc.identifier.doi10.1017/S1049023X18000626
dc.identifier.pmid30129913
dc.identifier.urihttp://hdl.handle.net/20.500.14038/28477
dc.description<p>Virginia B. Mangolds participated in this study as a doctoral student in the Graduate School of Nursing at UMass Medical School.</p>
dc.description.abstractIntroduction. The most commonly used methods for triage in mass-casualty incidents (MCIs) rely upon providers to take exact counts of vital signs or other patient parameters. The acuity and volume of patients which can be present during an MCI makes this a time-consuming and potentially costly process. Hypothesis. This study evaluates and compares the speed of the commonly used Simple Triage and Rapid Treatment (START) triage method with that of an "intuitive triage" method which relies instead upon the abilities of an experienced first responder to determine the triage category of each victim based upon their overall first-impression assessment. The research team hypothesized that intuitive triage would be faster, without loss of accuracy in assigning triage categories. METHODS: Local adult volunteers were recruited for a staged MCI simulation (active-shooter scenario) utilizing local police, Emergency Medical Services (EMS), public services, and government leadership. Using these same volunteers, a cluster randomized simulation was completed comparing START and intuitive triage. Outcomes consisted of the time and accuracy between the two methods. RESULTS: The overall mean speed of the triage process was found to be significantly faster with intuitive triage (72.18 seconds) when compared to START (106.57 seconds). This effect was especially dramatic for Red (94.40 vs 138.83 seconds) and Yellow (55.99 vs 91.43 seconds) patients. There were 17 episodes of disagreement between intuitive triage and START, with no statistical difference in the incidence of over- and under-triage between the two groups in a head-to-head comparison. CONCLUSION: Significant time may be saved using the intuitive triage method. Comparing START and intuitive triage groups, there was a very high degree of agreement between triage categories. More prospective research is needed to validate these results.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=30129913&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1017/S1049023X18000626
dc.subjectEMS Emergency Medical Services
dc.subjectFSE full-scale exercise
dc.subjectMCI mass-casualty incident
dc.subjectSTART Simple Triage and Rapid Treatment
dc.subjectEMS
dc.subjectdisaster
dc.subjectmass casualty
dc.subjecttriage
dc.subjectEmergency Medicine
dc.subjectHealth Services Administration
dc.titleIntuitive versus Algorithmic Triage
dc.typeArticle
dc.source.journaltitlePrehospital and disaster medicine
dc.source.volume33
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/emed_pp/167
dc.identifier.contextkey13424026
html.description.abstract<p>Introduction. The most commonly used methods for triage in mass-casualty incidents (MCIs) rely upon providers to take exact counts of vital signs or other patient parameters. The acuity and volume of patients which can be present during an MCI makes this a time-consuming and potentially costly process.</p> <p>Hypothesis. This study evaluates and compares the speed of the commonly used Simple Triage and Rapid Treatment (START) triage method with that of an "intuitive triage" method which relies instead upon the abilities of an experienced first responder to determine the triage category of each victim based upon their overall first-impression assessment. The research team hypothesized that intuitive triage would be faster, without loss of accuracy in assigning triage categories.</p> <p>METHODS: Local adult volunteers were recruited for a staged MCI simulation (active-shooter scenario) utilizing local police, Emergency Medical Services (EMS), public services, and government leadership. Using these same volunteers, a cluster randomized simulation was completed comparing START and intuitive triage. Outcomes consisted of the time and accuracy between the two methods.</p> <p>RESULTS: The overall mean speed of the triage process was found to be significantly faster with intuitive triage (72.18 seconds) when compared to START (106.57 seconds). This effect was especially dramatic for Red (94.40 vs 138.83 seconds) and Yellow (55.99 vs 91.43 seconds) patients. There were 17 episodes of disagreement between intuitive triage and START, with no statistical difference in the incidence of over- and under-triage between the two groups in a head-to-head comparison.</p> <p>CONCLUSION: Significant time may be saved using the intuitive triage method. Comparing START and intuitive triage groups, there was a very high degree of agreement between triage categories. More prospective research is needed to validate these results.</p>
dc.identifier.submissionpathemed_pp/167
dc.contributor.departmentGraduate School of Nursing
dc.contributor.departmentDepartment of Emergency Medicine
dc.contributor.departmentSchool of Medicine
dc.source.pages355-361


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