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Related Experiment Videos

Comparative analysis of multiple-casualty incident triage algorithms.

A Garner1, A Lee, K Harrison

  • 1CareFlight/NSW Medical Retrieval Service, Sydney, New South Wales, Australia. alang@careflight.org

Annals of Emergency Medicine
|October 27, 2001
PubMed
Summary

The Motor Component of the Glasgow Coma Scale and systolic blood pressure best predict critical injury. While several triage algorithms showed similar sensitivity, CareFlight Triage offered superior specificity for mass casualty incidents.

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Area of Science:

  • Emergency Medicine
  • Trauma Surgery
  • Public Health

Background:

  • Accurate patient triage is critical during mass casualty incidents (MCIs).
  • Existing triage algorithms and their physiological variables require validation for predicting critical injury.

Purpose of the Study:

  • To retrospectively assess the accuracy of MCI triage algorithms and their physiological components in identifying critically injured adult patients.
  • To compare the predictive performance of Triage Sieve, Simple Triage and Rapid Treatment (START), modified START, and CareFlight Triage.

Main Methods:

  • Retrospective review of 1,144 adult patients admitted to trauma centers.
  • Analysis of associations between out-of-hospital physiological variables and a resource-based definition of severe injury.

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  • Evaluation of triage algorithms including Triage Sieve, START, modified START, and CareFlight Triage.

    • Main Results:

    • The Motor Component of the Glasgow Coma Scale and systolic blood pressure demonstrated the strongest association with severe injury.
    • CareFlight Triage, START, and modified START showed comparable sensitivities (82-85%) for predicting critical injury.
    • CareFlight Triage exhibited higher specificity (96%) compared to START (86%) and modified START (91%).
    • Triage Sieve algorithms were significantly less effective predictors of severe injury.

    Conclusions:

    • Motor Glasgow Coma Scale and systolic blood pressure are key physiological predictors of severe injury.
    • CareFlight Triage demonstrated superior specificity in identifying critical trauma patients compared to START and modified START.
    • Findings require prospective validation, as patient populations in actual MCIs may differ from those in this study.