The reality of multiple casualty triage: putting triage theory into practice at the scene of multiple casualty vehicular accidents

Abstract

The research describes an extended and broadened triage process returning to a more authentic definition of triage as the practice of sorting of casualties to determine priority. The findings highlight the need to consider triage as an extended and complex process that incorporates evidence based physiological cues to assist decision making and the management of the process of triage from call out to conclusion including assessment of contextual and situational variables.

Can teaching methods based on pattern recognition skill development optimise triage in mass-casualty incidents?

“…Arbon et al 8 and Fry et al 9 showed that even when triage is highly protocolised, individuals call upon complex cognitive processes to make their decision. It is often based on their experience and knowledge, which are immediately available resources, compared with physiological parameters used in triage scales 8.…”

“…It is often based on their experience and knowledge, which are immediately available resources, compared with physiological parameters used in triage scales 8. In other words, personal judgement is always part of the decision-making process and may even prevail over the use of triage instruments in experienced healthcare providers 8.…”

“…It is often based on their experience and knowledge, which are immediately available resources, compared with physiological parameters used in triage scales 8. In other words, personal judgement is always part of the decision-making process and may even prevail over the use of triage instruments in experienced healthcare providers 8. In addition, it has been shown with paramedics that combining triage scales with their judgement was more efficient than the application of one without the other 10.…”

“…These observations led Arbon et al 8 to conclude that “There may be opportunities to enhance the current educational focus on training in the use of triage tools with greater discussion of a more experientially based and practical model.”…”

“…Unfortunately, Markenson et al 13 point out that “little guidance is currently available regarding the content and teaching methods that would be most appropriate to educate healthcare students” in this field. Therefore, according to Arbon et al ,8 “Further research is required (…) to introduce students to the contextual and situational cues that influence triage decision making.”…”