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Mass-Casualty Triage: Time for an Evidence-Based Approach

Published online by Cambridge University Press:  28 June 2012

Jennifer Lee Jenkins ,
Melissa L. McCarthy ,
Lauren M. Sauer ,
Gary B. Green ,
Stephanie Stuart ,
Tamara L. Thomas  and
Edbert B. Hsu
Jennifer Lee Jenkins*
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Melissa L. McCarthy
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Lauren M. Sauer
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Gary B. Green
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Stephanie Stuart
Affiliation:
The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Tamara L. Thomas
Affiliation:
Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA
Edbert B. Hsu
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
*
Assistant Chief of Service, Department of Emergency Medicine, The Johns Hopkins University 5801 Smith Avenue Davis Building Suite 3220 Baltimore, MD 21209 USA E-mail: jjenki36@jhmi.edu
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Abstract

Mass-casualty triage has developed from a wartime necessity to a civilian tool to ensure that constrained medical resources are directed at achieving the greatest good for the most number of people. Several primary and secondary triage tools have been developed, including Simple Treatment and Rapid Transport (START), JumpSTART, Care Flight Triage, Triage Sieve, Sacco Triage Method, Secondary Assessment of Victim Endpoint (SAVE), and Pediatric Triage Tape. Evidence to support the use of one triage algorithm over another is limited, and the development of effective triage protocols is an important research priority. The most widely recognized mass-casualty triage algorithms in use today are not evidence-based, and no studies directly address these issues in the mass-casualty setting. Furthermore, no studies have evaluated existing mass-casualty triage algorithms regarding ease of use, reliability, and validity when biological, chemical, or radiological agents are introduced. Currently, the lack of a standardized mass-casualty triage system that is well validated, reliable, and uniformly accepted, remains an important gap. Future research directed at triage is recognized as a necessity, and the development of a practical, universal, triage algorithm that incorporates requirements for decontamination or special precautions for infectious agents would facilitate a more organized mass-casualty medical response.

Keywords

evidence-based approachmass-casualty incidenttriage
Type
Review Article
Information
Prehospital and Disaster Medicine , Volume 23 , Issue 1 , February 2008 , pp. 3 - 8
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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