Triage decisions of prehospital emergency health care providers, using a multiple casualty scenario paper exercise.

Full Abstract

OBJECTIVE:
To examine the accuracy of theoretical triage decision making among emergency prehospital health care professionals, using a multiple casualty paper exercise.

METHODS:
A standardised 20 casualty paper exercise requiring each casualty to be prioritised for treatment was given to 100 doctors, 59 nurses, and 74 ambulance paramedics who could potentially be involved at the scene of a multiple casualty incident. Each paper was scored using the triage sieve algorithm. The paper contained descriptions of two casualties regarded as dead, six priority 1 casualties, six priority 2 casualties, and six priority 3 casualties.

RESULTS:
There was no significant difference in the scores received by both doctors and nurses, but paramedics did significantly less well than both nurses and doctors (p<0.05) However, the actual difference in mean scores is only just over 1; both doctors and nurses had a mean score of 13.03 and paramedics a mean score of 11.83. All professional groups tended to over triage patients. While there was no significant difference between doctors and nurses there was a significant difference (p<0.001) between paramedics and both doctors and nurses.

CONCLUSIONS:
There is little difference in the accuracy of triage decision making between the professional groups, with doctors and nurses scoring marginally better than paramedics. The rates of over triage are high posing the risk of overwhelming available resources further. Under triage rates are also high, with potentially life threatening conditions going unrecognised. However, some margin of error may be accounted for by the untested validity of the triage sieve methodology.

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Author information

Author/s: Kilner, T (T);

Affiliation: The University of Birmingham, School of Health Sciences, The Medical School, Edgbaston, Birmingham, UK. t.m.kilner(-atsign-)bham.ac.uk

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Emergency medicine journal : EMJ (Emerg Med J), published in England. (Language: eng)

Reference: 2002-Jul; vol 19 (issue 4) : pp 348-53

Dates: Created 2002/07/08; Completed 2002/09/27; Revised 2008/11/20;

PMID: 12101157, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Decision Making
Emergency Medical Services - manpower; statistics & numerical data
Emergency Medical Technicians
Great Britain

Great Britain
Humans
Nurses
Physicians
Triage

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