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. 2020 Aug 21;1(6):1185-1193.
doi: 10.1002/emp2.12235. eCollection 2020 Dec.

Going vertical: triage flags improve extraction times for priority patients

Abigail W Cheng  1 , Patrick McCreesh  1 , Seth Moffatt  1 , Ryan Maziarz  1 , Duncan Vos  2 , Joshua Mastenbrook  3
Affiliations

Going vertical: triage flags improve extraction times for priority patients

Abigail W Cheng et al. J Am Coll Emerg Physicians Open. .

Abstract

Objective: The number of mass casualty incidents (MCIs) has been steadily increasing. High-priority MCI patient outcomes are highly dependent on rapid identification, treatment, and transport. Although there are several methods used to mark patients for rapid extraction, most current methods utilize low-profile tags, with no gold standard. This study examines if the use of a vertical cue, a triage flag, to identify high priority MCI patients results in faster extraction times than those with a wrist triage tag alone.

Methods: A prospective randomized crossover study was conducted with medical students trained in basic disaster life support, who completed 2 extraction simulations. Two fields were each arranged with 32 randomly placed, pretriaged manikins (10 red, 17 yellow, 5 black). The manikins were marked with either triage tags alone or with triage tags and flags. The total time elapsed for participants to report all high-priority manikin triage tag numbers was recorded.

Results: Eighty-two participants completed both simulations. The average completion time for the "tags-only" simulation was 94.5 seconds (±16.4 seconds) compared to 70.7 seconds (±13.2 seconds) for the flags and tags simulation. This corresponds to an average decrease of 23.8 seconds (P < 0.0001), or a 25.2% reduction in time.

Conclusion: Using a vertical cue decreased the time required to identify high-priority patients. This suggests that a rapidly deployable and visually apparent triage marker may allow faster identification and extraction of patients across a field of victims with varying injury severities than a flat horizontal triage tag, thereby potentially improving patient outcomes.

Keywords: mass casualty incident; triage; triage tag.

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Conflict of interest statement

The authors report no conflicts of interest, financial or otherwise.

Figures

FIGURE 1
FIGURE 1
(A) “Flags and Tags” field (B) “Tags‐Only” field (C) “Tags‐Only” manikin (D) “Flags and Tags” manikin
FIGURE 2
FIGURE 2
Participant recruitment and flow of the “Tags‐Only” versus “Flags and Tags” trials
FIGURE 3
FIGURE 3
Distribution of completion times by treatment group and period
See this image and copyright information in PMC

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