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A concept for major incident triage: full-scaled simulation feasibility study.

Marius Rehn1, Jan E Andersen, Trond Vigerust

  • 1Norwegian Air Ambulance Foundation, Drøbak, Norway. marius.rehn@snla.no

BMC Emergency Medicine
|August 13, 2010
PubMed
Summary

The TAS-triage system significantly improved major incident response times and accuracy in simulated bus crashes. This modified triage Sieve tool proved feasible and efficient for emergency services.

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Area of Science:

  • Emergency Medicine
  • Disaster Management
  • Triage Systems

Background:

  • Efficient major incident management requires effective triage, treatment, and transport.
  • The Norwegian Air Ambulance Foundation developed the Interdisciplinary Emergency Service Cooperation Course (TAS) to standardize major incident management.
  • The TAS-triage concept, based on Sieve and Paediatric Triage Tape models, utilizes modified triage tags and stretchers.

Purpose of the Study:

  • To evaluate the feasibility and accuracy of the TAS-triage concept in simulated major incidents.
  • To assess the impact of the TAS-triage system on triage accuracy and time consumption.
  • To determine the effectiveness of interdisciplinary cooperation in major incident triage.

Main Methods:

  • Two standardized bus crash simulations were conducted: one without TAS-triage and one with TAS-triage and equipment.

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  • Triage accuracy and time consumption were measured by instructors.
  • Learners participated in a self-reported before-after study using a 7-point Likert scale to assess cooperation.

    • Main Results:

    • Without TAS-triage, simulations showed a mean over- and undertriage of 12%. With TAS-Triage, no mistriage occurred.
    • Average triage time decreased from 22 minutes to 10 minutes with TAS-triage.
    • Participant-reported interdisciplinary cooperation significantly improved after the TAS course (mean 4.9 to 5.8, p < 0.001).

    Conclusions:

    • The modified triage Sieve tool is feasible, time-efficient, and accurate for prioritizing patients in simulated bus accidents.
    • The TAS-triage concept demonstrates potential as a national standard for major incident triage.
    • The study highlights the benefits of standardized interdisciplinary training and equipment in major incident response.