Improved and sustained triage skills in firemen after a short training intervention

Abstract

BackgroundA previous study has shown no measurable improvement in triage accuracy among physicians attending the Advanced Trauma Life Support (ATLS) course and suggests a curriculum revision regarding triage. Other studies have indicated that cooperative learning helps students acquire knowledge.ObjectiveThe present study was designed to evaluate the effectiveness of trauma cards in triage training for firemen.MethodsEighty-six firemen were randomly assigned into two groups: the trauma card group and the direct instruction group. Both groups received the same 30-min PowerPoint lecture on how to perform triage according to the Sort Assess Lifesaving interventions Treatment and transport (SALT) Mass Casualty Triage Algorithm. In the trauma card group, the participants were divided into groups of 3–5 and instructed to triage 10 trauma victims according to the descriptions on the trauma cards. In the direct instruction group, written forms about the same 10 victims were used and discussed as a continuation of the PowerPoint lecture. Total training time was 60 min for both groups. A test was distributed before and after the educational intervention to measure the individual triage skills. The same test was applied again 6 months later.ResultsThere was a significant improvement in triage skills directly after the intervention and this was sustained 6 months later. No significant difference in triage skills was seen between the trauma card group and the direct instruction group. Previous experience of multi-casualty incidents, years in service, level of education or age did not have any measurable effects on triage accuracy.ConclusionsOne hour of triage training with the SALT Mass Casualty Triage Algorithm was enough to significantly improve triage accuracy in both groups of firemen with sustained skills 6 months later. Further studies on the first assessment on scene versus patient outcome are necessary to provide evidence that this training can improve casualty outcome. The efficacy and validity of trauma cards for disaster management training need to be tested in future studies.

Triage Performance of School Personnel Using the SALT System

“…The overall triage accuracy was similar to the 60%-80% observed in studies that evaluated medically trained personnel and other first responders. [6][7][8][9][10][13][14][15][16] The over-triage and under-triage rates were comparable to previously published studies with over-triage rates of 5%-23% 6,[8][9][10]13,14,17 and under-triage rates of 3%-33%. 6,[8][9][10][13][14][15][16] These results suggest that lay people may be trained to assist with MCI primary triage.…”

“…The training and application of triage principles has thus far been limited to medically trained personnel (ie, emergency medical technicians, nurses, physicians, and medical students) and other first responders (ie, firefighters and police officers). [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] No studies to date have examined triage training and application in the lay public. Often, the public is first on-scene during disasters and is in a unique position to sort, triage, and provide life-saving interventions to victims prior to EMS arrival.…”

Effect of Mass Casualty Training on Prehospital Care Providers in Kuwait

“…This indicates that short duration training of one or two days is sufficient for participants to understand the fundamentals of MCIs response competencies. This finding is consistent with a number of previous studies [16][17][18][19].…”

Sort, Assess, Life-Saving Intervention, Triage With Drone Assistance in Mass Casualty Simulation: Analysis of Educational Efficacy

“…An effective simulation is one in which participants learn to triage patients accurately. Although there is no accepted threshold for minimum accuracy, triage accuracy of approximately 52.43% is comparable to some studies of SALT triage and significantly less than other studies [ 10 , 13 , 15 , 16 ]. SALT remains one of the most consistent and accurate triage protocols used today, warranting further research to improve its quality and efficacy in simulation.…”