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Triage and trauma workload in mass casualty: a computer model.
Asher Hirshberg1, Eric R Frykberg, Kenneth L Mattox
1Department of Surgery, SUNY Downstate College of Medicine, Brooklyn, New York, USA. asher.hirshberg@gmail.com
The Journal of Trauma
|August 10, 2010
Summary
Hospital triage accuracy significantly impacts trauma team workload during mass casualty incidents. Optimizing triage strategies, like sequential competent triage, enhances trauma team capacity and improves response to mass casualty events.
Area of Science:
- Emergency Medicine
- Disaster Preparedness
- Health Systems Management
Background:
- Mass casualty incidents (MCIs) pose significant challenges to Emergency Department (ED) resources.
- Effective hospital triage is crucial for managing patient flow and optimizing trauma team workload during MCIs.
Purpose of the Study:
- To quantitatively analyze the impact of hospital triage on trauma team workload during MCIs.
- To evaluate how triage accuracy and mode influence trauma team capacity in high-casualty scenarios.
Main Methods:
- A computer model using the Monte Carlo method simulated casualty inflow and triage.
- Triage was modeled as a binary classification task (single or sequential steps).
- Key variables included triage accuracy (sensitivity, specificity), casualty load, and time to saturation (TTS) of trauma teams.
Main Results:
- Increasing casualty load resulted in a sigmoid-shaped time to saturation (TTS) curve.
- Enhanced triage accuracy extended TTS and shifted the curve rightward.
- Sequential competent triage (80% accuracy) matched perfect triage (100% accuracy) TTS, with less urgent casualty time investment; optimal sequential triage ratio is 1:8.
Conclusions:
- Innovative quantitative tools were developed for analyzing hospital triage during MCIs.
- Triage accuracy and mode critically affect trauma teams' ability to manage heavy casualty loads.
- These findings can inform optimized hospital responses to future mass casualty threats.
