Abstract
BackgroundThe pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation. The objective of the present study was to evaluate triage decision skills in a Mass Casualty Incident drill. The study compares two groups of participants in Advanced Trauma Life Support and Pre-Hospital Trauma Life Support courses.MethodsA questionnaire was used to deal with three components of triage of victims in a Mass Casualty Incident: decision-making; prioritization of 15 hypothetical casualties involved in a bus crash; and prioritization for evacuation. Swedish Advanced Trauma Life Support and Pre-Hospital Trauma Life Support course participants filled in the same triage skills questionnaire just before and after their respective course.ResultsOne hundred fifty-three advanced Trauma Life Support course participants were compared to 175 Pre-Hospital Trauma Life Support course participants. The response rates were 90% and 95%, respectively. A significant improvement was found between pre-test and post-test for the Pre-Hospital Trauma Life Support group in regards to decision-making. This difference was only noticeable among the participants who had previously participated in Mass Casualty Incident drills or had experience of a real event (pre-test mean ± standard deviation 2.4 ± 0.68, post-test mean ± standard deviation 2.60 ± 0.59, P = 0.04). No improvement was found between pre-test and post-test for either group regarding prioritization of the bus crash casualties or the correct identification of the most injured patients for immediate evacuation.ConclusionsNeither Advanced Trauma Life Support nor Pre-Hospital Trauma Life Support participants showed general improvement in their tested triage skills. However, participation in Mass Casualty Incident drills or experience of real events prior to the test performed here, were shown to be advantageous for Pre-Hospital Trauma Life Support participants. These courses should be modified in order to assure proper training in triage skills.
Highlights
The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation
Previous studies have indicated that the experience of physicians or prehospital personnel who have undergone training and who work daily in a pre-hospital setting can be of benefit during a Mass Casualty Incident (MCI) [4, 15, 16]
Data regarding the Advanced Trauma Life Support (ATLS) group was collected during a previously performed and published study [24]. It is used in context of comparison to the data gathered from the Pre-Hospital Trauma Life Support (PHTLS) course participants
Summary
The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation. Exercises and training are essential elements for health care personnel in order to be adequately prepared and reduce. Physicians involved in the initial patient treatment in a disaster situation could play a key role if they are properly prepared and trained in Advanced Trauma Life Support (ATLS) [13, 14]. Previous studies have indicated that the experience of physicians or prehospital personnel who have undergone training and who work daily in a pre-hospital setting can be of benefit during a Mass Casualty Incident (MCI) [4, 15, 16]
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