A consensus based template for reporting of pre-hospital major incident medical management

Fattah, Sabina; Rehn, Marius; Lockey, David; Thompson, Julian; Lossius, Hans Morten; Wisborg, Torben

doi:10.1186/1757-7241-22-5

Cited by 43 publications

(36 citation statements)

References 31 publications

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“…Since then, the numbers are slightly decreasing [ 1 ]. Despite ongoing efforts to implement major incidence registries [ 2 ], little is known on the incidence of sub-disaster mass casualty incidents (MCI). The notion that mortality in the MCI setting is still considerably higher than in individual cases [ 3 ] shows the necessity to further improve patient care in these situations.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a novel algorithm for primary mass casualty triage by paramedics in a physician manned EMS system: a dummy based trial

Wolf

Bigalke

Graf³

et al. 2014

Scand J Trauma Resusc Emerg Med

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BackgroundThe Amberg-Schwandorf Algorithm for Primary Triage (ASAV) is a novel primary triage concept specifically for physician manned emergency medical services (EMS) systems. In this study, we determined the diagnostic reliability and the time requirements of ASAV triage.MethodsSeven hundred eighty triage runs performed by 76 trained EMS providers of varying professional qualification were included into the study. Patients were simulated using human dummies with written vital signs sheets. Triage results were compared to a standard solution, which was developed in a modified Delphi procedure. Test performance parameters (e.g. sensitivity, specificity, likelihood ratios (LR), under-triage, and over-triage) were calculated. Time measurements comprised the complete triage and tagging process and included the time span for walking to the subsequent patient. Results were compared to those published for mSTaRT. Additionally, a subgroup analysis was performed for employment status (career/volunteer), team qualification, and previous triage training.ResultsFor red patients, ASAV sensitivity was 87%, specificity 91%, positive LR 9.7, negative LR 0.139, over-triage 6%, and under-triage 10%. There were no significant differences related to mSTaRT. Per patient, ASAV triage required a mean of 35.4 sec (75th percentile 46 sec, 90th percentile 58 sec). Volunteers needed slightly more time to perform triage than EMS professionals. Previous mSTaRT training of the provider reduced under-triage significantly. There were significant differences in time requirements for triage depending on the expected triage category.ConclusionsThe ASAV is a specific concept for primary triage in physician governed EMS systems. It may detect red patients reliably. The test performance criteria are comparable to that of mSTaRT, whereas ASAV triage might be accomplished slightly faster. From the data, there was no evidence for a clinically significant reliability difference between typical staffing of mobile intensive care units, patient transport ambulances, or disaster response volunteers. Up to now, there is no clinical validation of either triage concept. Therefore, reality based evaluation studies are needed.

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Section: Introductionmentioning

confidence: 99%

Evaluation of a novel algorithm for primary mass casualty triage by paramedics in a physician manned EMS system: a dummy based trial

Wolf

Bigalke

Graf³

et al. 2014

Scand J Trauma Resusc Emerg Med

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“…Acceptance rate is still close to 40%, with some 12% of accepted papers being systematic reviews and meta-analyses [ 4 - 9 ], and the gross volume original research papers covering a wide range of research methodology. The Journal continues to support consensus reports [ 10 - 12 ], and remains the vehicle for abstracts from national and international meetings [ 13 - 15 ]. Randomized design and multicentre studies are increasingly accepted [ 16 - 19 ], as well as the protocols for future planned and ongoing studies [ 16 , 20 , 21 ].…”

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confidence: 99%

Editorial: facts, figures and the future

Søreide

2015

Scand J Trauma Resusc Emerg Med

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“…11 The template is freely available and can be downloaded from http://www .majorincidentreporting.org. Reporting and access to already deposited reports is free.…”

Section: Sirmentioning

confidence: 99%

Dabigatran anticoagulation and Stanford type A aortic dissection: not always a lethal coincidence?

Williamson

Maxwell²,

Silvers³

et al. 2014

Acta Anaesthesiol Scand

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induction. Therefore, we also agree that a different median effective dose of dexmedetomidine for LMA insertion would have been obtained if we waited for 15 min. 2 However, during anaesthesia induction, where loss of consciousness is achieved with a hypnotic drug like propofol in our study, the situation is different than when dexmedetomidine is used alone in patients, and even more so in volunteers. In addition, Uzümcügil and colleagues 3 also reported that when dexmedetomidine 1 μg/kg was given 2 min before propofol induction, LMA insertion conditions were comparable with a situation where a combination of propofol and fentanyl 1 μg/kg was given. The haemodynamic effects may also be different during anaesthesia induction, and we did not observe any clinical change in mean arterial pressure before LMA insertion.Therefore, concerning LMA insertion conditions and haemodynamic effects, it may be appropriate to insert an LMA 2 min after dexmedetomidine, instead of 15 min, in the busy clinical setting during anaesthesia induction.

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A consensus based template for reporting of pre-hospital major incident medical management

Cited by 43 publications

References 31 publications

Evaluation of a novel algorithm for primary mass casualty triage by paramedics in a physician manned EMS system: a dummy based trial

Evaluation of a novel algorithm for primary mass casualty triage by paramedics in a physician manned EMS system: a dummy based trial

Editorial: facts, figures and the future

Dabigatran anticoagulation and Stanford type A aortic dissection: not always a lethal coincidence?

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