Performance characteristics of five triage tools for major incidents involving traumatic injuries to children

Abstract

Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work by researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available.Copies of full items can be used for personal research or study, educational, or not-forprofit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. Results: Of the 31,292 cases, 1,029 died (3.3%), 6,842 (21.9%) had major trauma (defined by an injury severity score > 15) and 14,711 (47%) were aged eight years or younger. There was variation in the performance accuracy of the tools to predict major trauma or death (sensitivities ranging between 36.4% and 96.2%; specificities 66.0% to 89.8%). Performance 3 characteristics varied with the age of the child. CareFlight had the best overall performance at predicting death, with the following sensitivity and specificity (95% CI) respectively: 95.3% (93.8 to 96.8) and 80.4% (80.0 to 80.9). JumpSTART was superior for the triaging of children under 8 years; sensitivity and specificity (95% CI) respectively: 86.3% (83.1 to 89.5) and 84.8% (84.2 to 85.5). The triage tools were generally better at identifying patients who would die than those with non-fatal severe injury. Conclusion:This statistical evaluation has demonstrated variability in the accuracy of triage tools at predicting outcomes for children who sustain traumatic injuries. No single tool performed consistently well across all evaluated scenarios.

Management of Multi-Casualty Incidents in Mountain Rescue: Evidence-Based Guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

“…The Medical Commander should have a clear picture of the overall MCI and be able to allocate the resources. Studies comparing triage systems illustrate that performance can be specific to the environment in which they are applied (Sacco et al, 2005 ; Culley et al, 2014 ; Vassallo et al, 2014 ; Price et al, 2016 ).…”

Hospitals’ Preparedness to Treat Pediatric Patients During Mass Casualty Incidents

“…It seems likely that adopting multiple triage methods would not be practical and could cause confusion during a mass casualty incident. Moreover, it is not easy to select a triage method that is suitable for younger children because there are no marked differences in accuracy for children among triage methods 10 . It may be necessary to tolerate a high rate of over-triaging among young children during primary triage by the START method, while appropriately classifying children by more accurate secondary triage performed when time and resources are available.…”

TRIAGE : Management of the trauma patient

“…There is extensive research published on triage in an MCI scenario, yet few studies address the validation of triage tools [41][42][43][44]. The lack of standardized mass casualty triage algorithms has the potential to cause significant confusion.…”