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Use and Analysis of Field Triage Criteria for Mass Gatherings

Published online by Cambridge University Press:  28 June 2012

Steven D. Salhanick*
Affiliation:
Program in Toxicology, Children's Hospital, Boston, Massachusetts USA
William Sheahan
Affiliation:
Emergency Medical Services Coordinator, Livingston County, New York USA
Jeffrey J. Bazarian
Affiliation:
Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York USA
*
Program in Toxicology, Division of Emergency Medicine, Children's Hospital, Boston, I. C. Smith Building, 300 Longwood Avenue, Boston, MA 02115 USA, E-mail: steven.salhanick@childrens.harvard.edu

Abstract

Introduction:

Mass gatherings may result in an acute increase in the number of people seeking medical care potentially causing undue stress to local emergencymedical services (EMS) and hospitals. Often, temporary medical facilities are established within the mass gathering venue. Emergency Medical Services providers encountering patients in the field should be equipped with effective protocols to determine transport destination (venue facility vs. hospital).

Hypothesis:

Paramedics are capable of appropriately using triage criteria written specifically for a particular mass gathering. The use of triage criteria, when appliedcorrectly, decreases over-triage to the venue facility and under-triage to the hospital.

Methods:

Paramedics triaged patients at a mass gathering to a temporary venue facility or to a single emergency department using criteria specific for the event. Cases were reviewed to determine if the patients transported went to an appropriate facility and if the triage criteria were applied appropriately. Results: Transport destination was consistent with that dictated by the criteria for 78% of cases. Analysis of these cases shows that the criteria had a sensitivity of 100% (95% CI = 58–100%) and a specificity of 90% (95% CI = 73–98%) for predicting which patients needed hospital services and which could be cared for safely in the temporary clinic setting.

Conclusions:

Triage by paramedics at the point of patient contact may reduce transporting of patients to hospitals unnecessarily. Patients in need of hospital services were identified. Point-of-contact triage should be applied in mass gatherings.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2003

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