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First Responder Accuracy Using SALT after Brief Initial Training.

Christopher W C Lee1, Shelley L McLeod1, Michael B Peddle1

  • 11Division of Emergency Medicine,Department of Medicine,Schulich School of Medicine and Dentistry,Western University,London,Ontario,Canada.

Prehospital and Disaster Medicine
|October 10, 2015
PubMed
Summary

First responders, including primary care paramedics (PCPs) and fire trainees, can accurately use the Sort, Assess, Life-saving interventions, Treatment/transport (SALT) triage tool after brief training. Police trainees showed lower accuracy in applying the SALT tool for mass-casualty incidents.

Keywords:
AssessEMS Emergency Medical ServicesEmergency Medical ServicesLife-saving interventionsMCI mass-casualty incidentPCP primary care paramedicSALT SortSTART Simple Triage and Rapid TreatmentTreatment/transportfire and rescue personnelmass-casualty incidentspolicetriage

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Area of Science:

  • Emergency Medical Services
  • Disaster Preparedness
  • Triage Systems

Background:

  • Mass-casualty incidents (MCIs) strain Emergency Medical Services (EMS) resources, necessitating optimized triage.
  • Integrating fire and police personnel into triage can reduce patient assessment times during MCIs.
  • The Sort, Assess, Life-saving interventions, Treatment/transport (SALT) tool is an internationally recognized MCI triage method.

Purpose of the Study:

  • To evaluate the accuracy of first-year primary care paramedic (PCP), fire, and police trainees in applying the SALT triage tool.
  • To assess knowledge retention of the SALT tool three months after initial training.
  • To compare the performance of different first responder trainees in using the SALT tool.

Main Methods:

  • A 30-minute didactic training session on the SALT tool was provided to PCP, fire, and police foundation program students.
  • A 17-item paper-based test was administered immediately after training and again three months later to assess SALT application and retention.
  • 464 trainees completed the initial test, with 364 participating in the three-month follow-up.

Main Results:

  • Initial test scores showed PCPs (87.0%) and fire trainees (80.2%) outperformed police trainees (68.0%).
  • Mean test scores decreased from 75% immediately after training to 64.7% at three months.
  • At three months, PCP (75.4%) and fire (71.4%) trainees demonstrated similar accuracy, significantly higher than police trainees (57.8%). Over-triage was the most common error.

Conclusions:

  • PCPs and fire trainees demonstrated the highest accuracy in applying the SALT triage tool among the studied first responder groups.
  • While initial accuracy was higher, a significant decline in performance was observed three months post-training, particularly for police trainees.
  • Over-triage errors were prevalent, highlighting a potential area for improvement in MCI triage training for all first responders.