Advancing the scientific study of prehospital mass casualty response through a Translational Science process: the T1 scoping literature review stage

Abstract

Purpose: The European Union Horizon 2020 research and innovation funding program awarded the NIGHTINGALE grant to develop a toolkit to support first responders engaged in prehospital (PH) mass casualty incident (MCI) response. To reach the projects' objectives, the NIGHTINGALE consortium used a Translational Science (TS) process. The present work is the first TS stage (T1) aimed to extract data relevant for the subsequent modified Delphi study (T2) statements.

Methods: The authors were divided into three work groups (WGs) MCI Triage, PH Life Support and Damage Control (PHLSDC), and PH Processes (PHP). Each WG conducted simultaneous literature searches following the PRISMA extension for scoping reviews. Relevant data were extracted from the included articles and indexed using pre-identified PH MCI response themes and subthemes.

Results: The initial search yielded 925 total references to be considered for title and abstract review (MCI Triage 311, PHLSDC 329, PHP 285), then 483 articles for full reference review (MCI Triage 111, PHLSDC 216, PHP 156), and finally 152 articles for the database extraction process (MCI Triage 27, PHLSDC 37, PHP 88). Most frequent subthemes and novel concepts have been identified as a basis for the elaboration of draft statements for the T2 modified Delphi study.

Conclusion: The three simultaneous scoping reviews allowed the extraction of relevant PH MCI subthemes and novel concepts that will enable the NIGHTINGALE consortium to create scientifically anchored statements in the T2 modified Delphi study.

Keywords: Damage control interventions; Mass casualty incident; NIGHTINGALE project; Scoping review; Translational science.

Fig. 1

Evolution of the structure and methodology adopted between the TIIDE and NIGHTINGALE project. ACEP American College of Emergency Physicians, ACS-COT American College of Surgeons-Committee on Trauma, AMA American Medical Association, ASL2 Azienda Sociosanitaria Ligure 2 (Italy), EMS Emergency Medical Services, ESTES European Society for Trauma and Emergency Surgery, MCI Mass Casualty Incidents, MDA Magen David Adom—Israel National Emergency Pre-Hospital Medical and Blood Services, MININT Ministry of Interior Italy, MRMID Swedish International Association for Promotion of Education and Training in Major Incidents and Disasters, MUCC Model Uniform Core Criteria for Mass Casualty Triage, NAEMT National Association of Emergency Medical Technicians (US), NAEMSE  National Association of Emergency Medical System Educators (US), NAEMSP National Association of Emergency Medical System Physicians (US), NASEMSO National Association of State Emergency Medical System Officials (US), SAMU Service d'Aide Médicale Urgente, Paris (France), SALT Sort, Assess, Life-Saving interventions, Treatment and/or Transport, UPO Università del Piemonte Orientale (Italy), USCS Università Cattolica del Sacro Cuore (Italy)