Ein regional angepasstes Vorgehen zur Vorsichtung und Sichtungskennzeichnung beim Massenanfall von Verletzten

Dittmar, M.; Bigalke, Marc U; Brunner, Alfred; Hannewald, W.; Hönig, Dietmar; Hönig, Manfred; Kiener, W.; Kopf, H; Schmidt, Tuany Rafaeli; Seeliger, J.; Birkholz, Torsten

doi:10.1055/s-0033-1349617

Cited by 13 publications

(15 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Accepted requirements for primary triage algorithms are simplicity [ 16 ],[ 10 ],[ 12 ], and to refrain from time consuming counting the respiratory frequency during primary triage [ 10 ]. Both aspects have been addressed in ASAV by reducing decision steps concerning respiration to a single one, and replacing respiratory frequency by a short list of distinct breathing disorders, which are not based on measured values.…”

Section: Discussionmentioning

confidence: 99%

“…To answer this question, further studies are needed. The fact that mSTaRT experienced study participants performed weaker in regard to bleeding control decisions had no obvious explanation, since both concepts include literally the same indication (“spurting haemorrhage”) [ 19 ],[ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“… The Amberg-Schwandorf Algorithm for Primary Triage (ASAV) (modified from Dittmar et al [ [ 12 ] ], with permission). …”

Section: Methodsmentioning

confidence: 99%

“…Simplified algorithmic decision making and avoidance of withholding lifesaving interventions are therefore core requirements for primary triage by non-physician EMS personnel. Taking this into account, we adapted the mSTaRT primary triage algorithm [ 9 ] for the use in our physician based EMS system, resulting in the Amberg-Schwandorf Algorithm for Primary Triage ( Amberg-Schwandorf-Algorithmus für die Vorsichtung , ASAV) [ 12 ]. Although results of primary EMS triage have a preliminary character, the algorithm must prove its reliability as a diagnostic test.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Evaluation of a novel algorithm for primary mass casualty triage by paramedics in a physician manned EMS system: a dummy based trial

Wolf

Bigalke

Graf³

et al. 2014

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

BackgroundThe Amberg-Schwandorf Algorithm for Primary Triage (ASAV) is a novel primary triage concept specifically for physician manned emergency medical services (EMS) systems. In this study, we determined the diagnostic reliability and the time requirements of ASAV triage.MethodsSeven hundred eighty triage runs performed by 76 trained EMS providers of varying professional qualification were included into the study. Patients were simulated using human dummies with written vital signs sheets. Triage results were compared to a standard solution, which was developed in a modified Delphi procedure. Test performance parameters (e.g. sensitivity, specificity, likelihood ratios (LR), under-triage, and over-triage) were calculated. Time measurements comprised the complete triage and tagging process and included the time span for walking to the subsequent patient. Results were compared to those published for mSTaRT. Additionally, a subgroup analysis was performed for employment status (career/volunteer), team qualification, and previous triage training.ResultsFor red patients, ASAV sensitivity was 87%, specificity 91%, positive LR 9.7, negative LR 0.139, over-triage 6%, and under-triage 10%. There were no significant differences related to mSTaRT. Per patient, ASAV triage required a mean of 35.4 sec (75th percentile 46 sec, 90th percentile 58 sec). Volunteers needed slightly more time to perform triage than EMS professionals. Previous mSTaRT training of the provider reduced under-triage significantly. There were significant differences in time requirements for triage depending on the expected triage category.ConclusionsThe ASAV is a specific concept for primary triage in physician governed EMS systems. It may detect red patients reliably. The test performance criteria are comparable to that of mSTaRT, whereas ASAV triage might be accomplished slightly faster. From the data, there was no evidence for a clinically significant reliability difference between typical staffing of mobile intensive care units, patient transport ambulances, or disaster response volunteers. Up to now, there is no clinical validation of either triage concept. Therefore, reality based evaluation studies are needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“… The Amberg-Schwandorf Algorithm for Primary Triage (ASAV) (modified from Dittmar et al [ [ 12 ] ], with permission). …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of a novel algorithm for primary mass casualty triage by paramedics in a physician manned EMS system: a dummy based trial

Wolf

Bigalke

Graf³

et al. 2014

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…In aktuellen Studien wurde die Qualität verschiedener in Deutschland gebräuchlicher Vorsichtungsalgorithmen hinsichtlich der korrekten Identifizierung der SK I untersucht. Die Algorithmen ASAV [5] und mSTaRT [6] erzielten dabei die besten Ergebnisse hinsichtlich Sensitivität und Spezifitätalso ob möglichst alle vital bedrohten Patienten als SK I erkannt und keine leichter Verletzten als SK I triagiert wurden [7,8] Eine weitere Fehlerquelle steckt diesbezüglich im zeitigen Aussortieren der gehfähigen Patienten. Wenn gehfähige Patienten ganz am Anfang des Algorithmus als "grün" aussortiert werden, können in dieser Gruppe noch bis zu 28 % "rote" Patienten stecken.…”

Section: Qualität Verfügbarer Vorsichtungsalgorithmenunclassified

Triage beim Massenanfall von Verletzten (MANV)

Neidel¹,

Heller²

2018

Notf.med. up2date

View full text Add to dashboard Cite

Patientenwille und Akutmedizin

Wurmb

Brederlau

2015

Med Klin Intensivmed Notfmed

View full text Add to dashboard Cite

Patients with complex medical problems and acute life-threatening diseases deserve a physician with the capability of rapid decision making. Despite an emergency scenario with several unknown or uncertain variables an individual therapeutic plan needs to be defined for each patient. In order to achieve this goal the physician must define medical indications for each form of treatment. Secondly, the patients declared intentions must be respected concerning the previously defined medical indications; however, very often the patients' will is not known. It is very difficult to define an individual treatment plan especially if the patient is not able to adequately communicate. In these situations a custodian is helpful to find out the patients declared intentions towards the current medical situation. If there is no advance directive, family members often have to act as surrogates to find out what therapy goal is best for the individual patient. The patients' autonomy is a very highly respected ethical priority even when the ability for the otherwise usual practice of shared decision-making between physician and patient is compromised. Therefore, in order to do justice to this demanding situation it is necessary to deal with the characteristics of the physician-patient-relatives relationship in emergency medicine.

show abstract

Ein regional angepasstes Vorgehen zur Vorsichtung und Sichtungskennzeichnung beim Massenanfall von Verletzten

Cited by 13 publications

References 9 publications

Evaluation of a novel algorithm for primary mass casualty triage by paramedics in a physician manned EMS system: a dummy based trial

Evaluation of a novel algorithm for primary mass casualty triage by paramedics in a physician manned EMS system: a dummy based trial

Triage beim Massenanfall von Verletzten (MANV)

Patientenwille und Akutmedizin

Contact Info

Product

Resources

About