A review of the literature on the validity of mass casualty triage systems with a focus on chemical exposures

Culley, Joan M.; Svendsen, Erik

doi:10.5055/ajdm.2014.0150

Cited by 30 publications

(11 citation statements)

References 86 publications

(125 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 30 In agreement with the results, Culley et al. 31 show that there is an imbalance in chemical crises between the number of the wounded and the medical facilities. Many of the wounded do not need special medical activities.…”

Section: Discussionsupporting

confidence: 77%

Experiences of civilian nurses in triage during the Iran-Iraq War: An oral history

Firouzkouhi

Zargham-Boroujeni

Kako

et al. 2017

Chinese Journal of Traumatology

View full text Add to dashboard Cite

PurposeNurses played a critical role in performing triage during the Iran-Iraq War. However, their experiences in triage have not been discussed. Therefore, the current study aimed to investigate the triage experiences of civilian nurses during the Iran-Iraq War.MethodsOral history method and in-depth interviews were used to collect data to gain the nurses' experiences in triage.ResultsFour themes were extracted from the data, which were the development of triage, challenging environment to perform triage, development of mobile triage teams, and challenges of triage chemical victims for nurses.ConclusionTriage is an important skill for nurses to manage critical situations such as disasters and wars. Nurses have to be competent in performing triage. Involvement in critical situations helps the nurses learn and gain more experience on how to manage unexpected events.

show abstract

Section: Discussionsupporting

confidence: 77%

Experiences of civilian nurses in triage during the Iran-Iraq War: An oral history

Firouzkouhi

Zargham-Boroujeni

Kako

et al. 2017

Chinese Journal of Traumatology

View full text Add to dashboard Cite

show abstract

“…However, the simplistic nature of these triage systems is not a reflection of their ability to optimize patient outcome. In fact, the effectiveness of these triage models to accurately triage patients in an MCI is widely unproven [11-13]. …”

Section: Methodsmentioning

confidence: 99%

Mobile Decision Support Tool for Emergency Departments and Mass Casualty Incidents (EDIT): Initial Study

Boltin¹,

Valdes²,

Culley³

et al. 2018

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

BackgroundChemical exposures pose a significant threat to life. A rapid assessment by first responders and emergency nurses is required to reduce death and disability. Currently, no informatics tools exist to process victims of chemical exposures efficiently. The surge of patients into a hospital emergency department during a mass casualty incident creates additional stress on an already overburdened system, potentially placing patients at risk and challenging staff to process patients for appropriate care and treatment efficacy. Traditional emergency department triage models are oversimplified during highly stressed mass casualty incident scenarios in which there is little margin for error. Emerging mobile technology could alleviate the burden placed on nurses by allowing the freedom to move about the emergency department and stay connected to a decision support system.ObjectiveThis study aims to present and evaluate a new mobile tool for assisting emergency department personnel in patient management and triage during a chemical mass casualty incident.MethodsOver 500 volunteer nurses, students, and first responders were recruited for a study involving a simulated chemical mass casualty incident. During the exercise, a mobile application was used to collect patient data through a kiosk system. Nurses also received tablets where they could review patient information and choose recommendations from a decision support system. Data collected was analyzed on the efficiency of the app to obtain patient data and on nurse agreement with the decision support system.ResultsOf the 296 participants, 96.3% (288/296) of the patients completed the kiosk system with an average time of 3 minutes, 22 seconds. Average time to complete the entire triage process was 5 minutes, 34 seconds. Analysis of the data also showed strong agreement among nurses regarding the app’s decision support system. Overall, nurses agreed with the system 91.6% (262/286) of the time when it came to choose an exposure level and 84.3% (241/286) of the time when selecting an action.ConclusionsThe app reliably demonstrated the ability to collect patient data through a self-service kiosk system thus reducing the burden on hospital resources. Also, the mobile technology allowed nurses the freedom to triage patients on the go while staying connected to a decision support system in which they felt would give reliable recommendations.

show abstract

“…2,21-23 Although these algorithms are well established, a recent review reported only moderate accuracy. 24 All existing algorithms do produce a considerable rate of undertriage (falsely lower category) and overtriage (falsely higher category). 23,25,26 Frykberg 27 analysed overtriage rates and mortality in several MCIs and found an almost linear positive correlation between the overtriage rate and mortality.…”

Section: Role Of Imagingmentioning

confidence: 98%

Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

Berger¹,

Körner²,

Bernstein³

et al. 2016

BJR

View full text Add to dashboard Cite

In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior training drills. Over the recent decades, imaging has increasingly been used to evaluate critically ill patients. It can also be used to increase the accuracy of triaging MCI victims, since overtriage (falsely higher triage category) and undertriage (falsely lower triage category) can severely impact resource availability and mortality rates, respectively. This article emphasizes the importance of including the radiology department in hospital preparations for a MCI and highlights factors expected to influence performance during hospital DMP activation including issues pertinent to effective simulation, such as establishing proper learning objectives. After-action reviews including performance evaluation and debriefing on issues are invaluable following simulation drills and DMP activation, in order to improve subsequent preparedness. Historically, most hospital DMPs have not adequately included radiology department operations, and they have not or to a little extent been integrated in the DMP activation simulation. This article aims to increase awareness of the need for radiology department engagement in order to increase radiology department preparedness for DMP activation after a MCI occurs.

show abstract

A review of the literature on the validity of mass casualty triage systems with a focus on chemical exposures

Cited by 30 publications

References 86 publications

Experiences of civilian nurses in triage during the Iran-Iraq War: An oral history

Experiences of civilian nurses in triage during the Iran-Iraq War: An oral history

Mobile Decision Support Tool for Emergency Departments and Mass Casualty Incidents (EDIT): Initial Study

Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

Contact Info

Product

Resources

About