Introduction of Pediatric Physiological and Anatomical Triage Score in Mass-Casualty Incident

Toida, Chiaki; Muguruma, Takashi; Abe, Takeru; Shinohara, Mafumi; Gakumazawa, Masayasu; Yogo, Naoki; Shirasawa, Aya; Morimura, Naoto

doi:10.1017/s1049023x18000109

Cited by 10 publications

(11 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some hospitals apply primary triage protocols, such as simple triage and rapid treatment (START), for secondary triage; however, understandably, they perform poorly in this setting. 44 Duplicating primary triage in hospital is not only unlikely to be effective for achieving the different objectives of secondary triage but also highly inefficient and fails to take into account the additional information available on which to base a secondary triage decision. In most situations, secondary triage is conducted by a single senior physician or surgeon or group of senior physicians or surgeons drawn from a variety of backgrounds, including emergency medicine, intensive care, or trauma surgery.…”

Section: Secondary Triagementioning

confidence: 99%

“…In most situations, secondary triage is conducted by a single senior physician or surgeon or group of senior physicians or surgeons drawn from a variety of backgrounds, including emergency medicine, intensive care, or trauma surgery. 28,[45][46][47] Toida and colleagues 44 developed the Pediatric Physiological and Anatomical Triage Score specifically for pediatric secondary triage for trauma and CBRNE (chemical, biological, radiological, nuclear, and explosive) -related disasters. Pneumonia severity scores 48,49 have been investigated for secondary triage in pandemics but found to perform poorly.…”

Section: Secondary Triagementioning

confidence: 99%

See 1 more Smart Citation

Triage

Christian

2019

Critical Care Clinics

View full text Add to dashboard Cite

KEYWORDS Triage Mass casualty incident Crisis response KEY POINTSTriage decision making is critical for a successful response to a mass casualty incident.How triage is applied differs across the surge response spectrum from conventional to crisis response. Disaster triage is a complex topic with which most clinicians have limited experience and often have difficulty in making the shift from the patient to population perspective to understand it well.Crit Care Clin 35 (2019) 575-589

show abstract

Section: Secondary Triagementioning

confidence: 99%

Section: Secondary Triagementioning

confidence: 99%

Triage

Christian

2019

Critical Care Clinics

View full text Add to dashboard Cite

show abstract

“…In terms of priority, patients with scores ≥six points were classified as "immediate." 9 In contrast, TRTS was based on RR, sBP, and GCS, with 12 being the highest possible score. Patients with scores between one to 10 points were assigned "immediate" priority ( Table 1).…”

Section: Criteria Of the Ppats And Trtsmentioning

confidence: 99%

“…[4][5][6][7][8] Previous study showed that the Pediatric Physiological and Anatomical Triage Score (PPATS) was developed as a new secondary triage method, with a scoring system for children in a disaster setting, since secondary triage is critical for refining the results of primary triage. 9 Because the previous study was a single-center study, this study was conducted as a multi-center study using data from the national registry of Japan. The aim of this study was to externally validate the PPATS for severe trauma patients, of whom will be the majority in disaster settings.…”

Section: Introductionmentioning

confidence: 99%

Validation of the Pediatric Physiological and Anatomical Triage Score in Injured Pediatric Patients

Muguruma

Toida

Furugori

et al. 2019

Prehosp. Disaster med.

Self Cite

View full text Add to dashboard Cite

Introduction:Triaging plays an important role in providing suitable care to a large number of casualties in a disaster setting. A Pediatric Physiological and Anatomical Triage Score (PPATS) was developed as a new secondary triage method. This study aimed to validate the accuracy of the PPATS in identifying injured pediatric patients who are admitted at a high frequency and require immediate treatment in a disaster setting. The PPATS method was also compared with the current triage methods, such as the Triage Revised Trauma Score (TRTS).Methods:A retrospective review of pediatric patients aged ≤15 years, registered in the Japan Trauma Data Bank (JTDB) from 2012 through 2016, was conducted and PPATS was performed. The PPATS method graded patients from zero to 22, and was calculated based on vital signs, anatomical abnormalities, and the need for life-saving interventions. It categorized patients based on their priority, and the intensive care unit (ICU)-indicated patients were assigned a PPATS ≥six. The accuracy of PPATS and TRTS in predicting the outcome of ICU-indicated patients was compared.Results:Of 2,005 pediatric patients, 1,002 (50%) were admitted to the ICU. The median age of the patients was nine years (interquartile range [IQR]: 6-13 years). The sensitivity and specificity of PPATS were 78.6% and 43.7%, respectively. The area under the receiver-operating characteristic (ROC) curve (AUC) was larger for PPATS (0.61; 95% confidence interval [CI], 0.59-0.63) than for TRTS (0.57; 95% CI, 0.56-0.59; P <.01). Regression analysis showed a significant correlation between PPATS and the Injury Severity Score (ISS; r2 = 0.353; P <.001), predicted survival rate (r2 = 0.396; P <.001), and duration of hospital stay (r2 = 0.252; P <.001).Conclusion:The accuracy of PPATS for injured pediatric patients was superior to that of current secondary triage methods. The PPATS method is useful not only for identifying high-priority patients, but also for determining the priority ranking for medical treatments and evacuation.

show abstract

“…To the Editor, The article by Takashi Muguruma, et al is inspiring. 1 It compared a triage system designed for pediatric patients, Pediatric Physiological and Anatomical Triage Score (PPATS), with a widely used triage method for generic patients, Triage Revised Trauma Score (TRTS), 2 and suggested that PPATS is a viable and useful triage method specifically for pediatric patients. 1 However, different disasters have their own characteristics of casualties.…”

mentioning

confidence: 99%