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Creation and Delphi-method refinement of pediatric disaster triage simulations.
Prehospital Emergency Care
|January 10, 2014
Summary
This study developed pediatric disaster triage (PDT) training simulations for paramedics. The modified Delphi process achieved high consensus among experts, ensuring unbiased and effective evaluation tools for prehospital training.
Area of Science:
- Emergency Medicine
- Medical Simulation
- Pediatric Care
Background:
- Paramedic training lacks rigorous pediatric disaster triage (PDT) simulations.
- Effective PDT tools are crucial for managing mass casualty incidents involving children.
Purpose of the Study:
- To design three multiple-patient incident (MPI) simulations for EMS provider training.
- To determine appropriate interventions and triage levels for pediatric victims in simulations.
- To develop unbiased simulation and evaluation tools for PDT.
Main Methods:
- Created mixed-methods disaster simulation scenarios (school shooting, bus crash, house fire) with pediatric victims.
- Utilized standardized patients and high/low-fidelity manikins for victim portrayal.
- Employed a modified Delphi iterative critique with Subject Matter Experts (SMEs) to refine simulations and evaluation tools.
Main Results:
- Achieved >85% consensus on expected triage levels for 28 of 30 victims after two Delphi rounds.
- Amended 11 instances of bias and corrected 10 instances of noncorrelation between evaluations and simulations.
- The modified Delphi process ensured high SME agreement on simulation validity and evaluation tool correlation.
Conclusions:
- The modified Delphi process successfully generated consensus-driven PDT simulation and evaluation tools.
- The developed tools are free of bias toward specific PDT strategies.
- These validated simulations and tools are ready for testing within prehospital PDT curricula.
