Comparing the Accuracy of Three Pediatric Disaster Triage Strategies: A Simulation-Based Investigation
Authors
Cicero, Mark X.Overly, Frank
Brown, Linda
Yarzebski, Jorge D.
Walsh, Barbara M.
Shabanova, Veronika
Auerbach, Marc
Riera, Antonio
Adelgais, Kathleen
Meckler, Garth
Cone, David
Baum, Carl R.
Document Type
Journal ArticlePublication Date
2016-04-01Keywords
emergency respondersmass casualty incidents
triage
vulnerable populations
Emergency Medicine
Medical Education
Pediatrics
Metadata
Show full item recordAbstract
BACKGROUND: It is unclear which pediatric disaster triage (PDT) strategy yields the best accuracy or best patient outcomes. METHODS: We conducted a cross-sectional analysis on a sample of emergency medical services providers from a prospective cohort study comparing the accuracy and triage outcomes for 2 PDT strategies (Smart and JumpSTART) and clinical decision-making (CDM) with no algorithm. Participants were divided into cohorts by triage strategy. We presented 10-victim, multi-modal disaster simulations. A Delphi method determined patients' expected triage levels. We compared triage accuracy overall and for each triage level (RED/Immediate, YELLOW/Delayed, GREEN/Ambulatory, BLACK/Deceased). RESULTS: There were 273 participants (71 JumpSTART, 122 Smart, and 81 CDM). There was no significant difference between Smart triage and CDM. When JumpSTART triage was used, there was greater accuracy than with either Smart (P < 0.001; OR [odds ratio]: 2.03; interquartile range [IQR]: 1.30, 3.17) or CDM (P=0.02; OR: 1.76; IQR: 1.10, 2.82). JumpSTART outperformed Smart for RED patients (P=0.05; OR: 1.48; IQR: 1.01,2.17), and outperformed both Smart (P < 0.001; OR: 3.22; IQR: 1.78,5.88) and CDM (P < 0.001; OR: 2.86; IQR: 1.53,5.26) for YELLOW patients. Furthermore, JumpSTART outperformed CDM for BLACK patients (P=0.01; OR: 5.55; IQR: 1.47, 20.0). CONCLUSION: Our simulation-based comparison suggested that JumpSTART triage outperforms both Smart and CDM. JumpSTART outperformed Smart for RED patients and CDM for BLACK patients. For YELLOW patients, JumpSTART yielded more accurate triage results than did Smart triage or CDM.Source
Disaster Med Public Health Prep. 2016 Apr;10(2):253-60. doi: 10.1017/dmp.2015.171. Epub 2016 Jan 8. Link to article on publisher's siteDOI
10.1017/dmp.2015.171Permanent Link to this Item
http://hdl.handle.net/20.500.14038/28908PubMed ID
26744228Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1017/dmp.2015.171