Health Professionals of Emergency Service: Evaluation of Triage and Ethical Values in Disaster Medicine

Abstract

Aim: To understand opinions of health professionals who work in emergency services about the application of basic concepts, such as triage, ethics, legal rules, to popularize problems they experience while they are providing health services after natural disasters, and to develop suggestions. Materials and Methods:In order to evaluate health service problems, a questionnaire tool was formulated regarding triage and ethics applications. The questionnaire was given to 133 emergency service workers with and without earthquake experiences. Data were analyzed using descriptive statistics with statistical significance set at p<0.001. The frequency distributions were taken into account and chi square test was performed to understand the differences between employees who had experienced earthquakes and those who had not. Results:In the survey, 57.7% of participants were male and 42.3% were female. The mean age of the participants' was 29.8 years; 16.8% of them worked in the university hospital, 77.4% in the state hospital, and 5.8% in private hospitals. Of the participants, 51.1% were doctors, 43.1% were nurses, and 5.8% were emergency medical technicians; 48.2% of participants had experienced an earthquake and 52.6% had not. In addition, 27% of the participants had to consult regarding triage; 37.2% on triage and legal rules; 31.4% on triage, laws, and ethics; and 4.4% on triage and ethical principles. Conclusion:The results show that triage and legal regulations play an essential role in resource allocation and medical service presentation, while ethical principles are less considered in medical services after natural disasters. Inclusion of ethical training in natural disaster medicine education and its enhancement through regular rehearsals are essential. (Eurasian J Emerg Med 2015; 14: 107-12)

Trends and ethical issues in nursing during disasters: A systematic review

“…The majority (73.3%) were published from 2020 to 2022 24–34 The study designs were cross-sectional (4/25, 26.6%), 24,30,35,36 qualitative (9/15, 60.0%), 26–29,31,33,34,37,38 and mixed methods (2/15, 13.3%). 25,32 Eight studies were conducted in-hospital and out-of-hospital (53.3%).…”

“…Most studies mention 25,26,31,34,36 that dilemmas and ethical issues use similar and related terms. For example, ethical issues can become ethical dilemmas when faced with limited choices and extreme situations.…”

“…In the findings of this systematic review of the literature, the most difficult ethical decision is regarding the principle of disaster triage because it requires nurses to allocate limited resources to save patients in a short time and sometimes decide on the fate of the patients due to the lack of time and limited available resources. 29,32,34,36…”

Evaluation of Ethical Dilemmas in Disaster Triage Example of İzmir

“…Benzer bir şekilde, Sevimli ve ark.nın 2015 yılında yapmış oldukları çalışmada da müdahale personelinin triaj uygulamaları sırasında karar verirken, etik ilke olarak hastanın yararına hareket etmenin ön plana geçtiği belirtilmiştir. 23…”

Sağlık Profesyonellerinin Afet Triajında Etik Karar Verebilme Durumları: İzmir İli Örneği

“…Ayrıca sağlık profesyonellerinin yaşanan afetlerden sonra, afetlerde triaj kararı verme, etik ilkeler ve yasal düzenlemelerin yapılması yönünde çeşitli eğilimlerin olduğunu ve bu eğilimlerin eğitim, pratik yapma ve değerlendirme konusunda ihtiyacın olduğunu gösterdiğini belirtmiştir. Ayrıca acil servis uzmanları, mevcut kaotik ortam ve koşullara paralel olarak, deprem gibi doğal felaketlerden sonra triyaj karar verme, etik ilkeler ve yasal düzenlemelerin yapılması yönünde çeşitli eğilimleri olduğunu belirtmiştir (20 (27). Bir diğer hipotezimiz olan "H2: Sağlık profesyonellerinin afet triajı etik bilgi düzeyleri afet triajında etik karar vermelerini etkiler."…”