Abstract
BackgroundTriage plays a crucial role in the emergency department (ED) management of mass casualty incidents (MCIs) when resources are limited. This study aimed to compare the performance of simple triage and rapid treatment (START) with that of the Taiwan Triage and Acuity Scale (TTAS) for the ED triage of victims following an earthquake-related MCI.MethodsWe retrospectively reviewed the records of victims presenting at our ED with earthquake-related injuries within 24 h of a large-scale earthquake. TTAS was initially used at our ED for this event, and START was performed by retrospectively reviewing the patient records in a blinded manner. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of START and TTAS were determined for predicting ED discharge.ResultsWe enrolled 105 patients (predominantly women, 60.0%; median age, 45.0 years) in this study; most of them presented with traumatic injuries and were initially triaged as TTAS level III (78.1%), followed by TTAS level II (11.4%). Although the majority of the victims (81.0%) were discharged, four deaths occurred. A moderate agreement in differentiating emergency from nonemergency patients was observed between START and TTAS. Furthermore, both the triage systems showed similar predictions for ED disposition (START AUC/sensitivity/specificity: 0.709/82.35%/55.00%; TTAS AUC/sensitivity/specificity: 0.709/90.59%/45.00%).ConclusionsThe present study demonstrated that START and TTAS have similar triage accuracy and ability to predict ED disposition. Our findings demonstrate that START may be used as an alternative to TTAS for the ED triage of victims following earthquake-related MCIs.
Highlights
Triage plays a crucial role in the emergency department (ED) management of mass casualty incidents (MCIs) when resources are limited
Most of them were initially triaged as Taiwan Triage and Acuity Scale (TTAS) level III (78.1%), followed by TTAS level II (11.4%)
The majority of the patients triaged using the simple triage and rapid treatment (START) protocol were classified into the minor category, followed by the delay, deceased, and immediate categories
Summary
Triage plays a crucial role in the emergency department (ED) management of mass casualty incidents (MCIs) when resources are limited. Field triage [1, 2] and hospital triage [3,4,5] play crucial roles in emergency medical care [6, 7]. The accuracy and efficiency of triage contribute to timely medical treatment and better patient outcomes [8]. Field triage and patient stabilization may not always be plausible, thereby leading to considerable challenges in the emergency department (ED) management of large-scale earthquake-related MCIs. an optimal triage system that considers time and precision may improve resource allocation, maintain ED operability, and provide effective treatment to victims
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