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Optimizing Triage in Chemical Disasters: Validation of Modified IGSA Criteria for Hydrofluoric Acid Exposure

Published online by Cambridge University Press:  03 January 2025

Heejun Shin Open the ORCID record for Heejun Shin [Opens in a new window] ,
Se Kwang Oh ,
Han You Lee ,
Heajin Chung ,
Ji Eun Moon  and
Hee Do Kang
Heejun Shin*
Affiliation:
Soonchunhyang (SCH) Disaster Medicine Fellowship, SCH Disaster Medicine Center at the Soonchunhyang University Hospital, Bucheon, Gyeonggi-do, Republic of Korea Department of Emergency Medicine, Soonchunhyang University Hospital, Bucheon, Republic of Korea
Se Kwang Oh
Affiliation:
Department of Emergency Medicine, Chungnam National University Hospital, Sejong, Republic of Korea
Han You Lee
Affiliation:
Department of Emergency Medicine, Soonchunhyang University Hospital, Cheonan, Republic of Korea
Heajin Chung
Affiliation:
Department of Emergency Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea
Ji Eun Moon
Affiliation:
Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
Hee Do Kang
Affiliation:
Department of Emergency Medicine, Soonchunhyang University Gumi Hospital, Republic of Korea
*
Corresponding author: Heejun Shin; Email: iamrocker@hanmail.net
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Abstract

Objective

This study aimed to develop and validate the modified irritant gas syndrome agent (IGSA) criteria, utilizing readily available triage information and epidemiologic data to efficiently segregate patients based on the severity of hydrofluoric acid (HFA) exposure.

Methods

A retrospective analysis of 160 patients exposed to HFA was performed to develop the criteria and assess the criteria’s efficacy, focusing on age, respiratory rate, and compliance with IGSA standards. The criteria’s validity was assessed by comparing clinical outcomes between patients meeting the modified IGSA (mIGSA) criteria and those who did not as external and internal.

Results

The mIGSA criteria (or AIR criteria) consisting of the 3 clusters of age greater than 49, IGSA criteria satisfied, and respiratory rate greater than 19 was developed. The area under curve of receiver operating characteristic curve for prediction of the risk of confirmed HFA injury according to AIR criteria was 0.8415 at the external validation.

Conclusions

The mIGSA criteria offer a significant improvement in the triage of HFA exposure incidents, facilitating rapid identification and prioritization of patients with potentially severe outcomes. Future research should aim to further validate these criteria across diverse emergency scenarios, reinforcing their utility in global health emergency preparedness.

Keywords

disastershydrofluoric acidstatistical factor analysistriage
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 18 , 2024 , e323
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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