Qualitative Analysis of Surveyed Emergency Responders and the Identified Factors That Affect First Stage of Primary Triage Decision-Making of Mass Casualty Incidents

Abstract

Introduction: After all large-scale disasters multiple papers are published describing the shortcomings of the triage methods utilized. This paper uses medical provider input to help describe attributes and patient characteristics that impact triage decisions.

Methods: A survey distributed electronically to medical providers with and without disaster experience. Questions asked included what disaster experiences they had, and to rank six attributes in order of importance regarding triage.

Results: 403 unique completed surveys were analyzed. 92% practiced a structural triage approach with the rest reporting they used "gestalt".(gut feeling) Twelve per cent were identified as having placed patients in an expectant category during triage. Respiratory status, ability to speak, perfusion/pulse were all ranked in the top three. Gut feeling regardless of statistical analysis was fourth. Supplies were ranked in the top four when analyzed for those who had placed patients in the expectant category.

Conclusion: Primary triage decisions in a mass casualty scenario are multifactorial and encompass patient mobility, life saving interventions, situational instincts, and logistics.

Keywords: Disaster medicine; Emergency management; Mass casualty care; Triage.

Table 1: Model Uniform Core Criteria for Mass Casualty (MUCC) triage

Table 2. Self reported medical occupations of respondents, all of who worked in emergency management areas. (N=403)

Mean rankings of triage factors by respondent's disasters experience level.

Table 3: Ranking differences of criteria separating experienced, black tag with and without disaster experience (163) vs. no disaster experience (240). (p<0.05 sig)

Percent of respondents by triage experience category, who ranked 'supplies' in the top four choices.

SALT Triage