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Development of a Pediatric Mass Casualty Triage Algorithm Validation Tool.

J Joelle Donofrio, Amy H Kaji, Ilene A Claudius

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    Summary

    A new Criteria Outcomes Tool (COT) was developed to validate mass casualty incident (MCI) triage algorithms for pediatric patients. This tool demonstrated good reproducibility in initial studies for emergency triage.

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    Area of Science:

    • Emergency Medicine
    • Disaster Preparedness
    • Pediatric Trauma

    Background:

    • Accurate mass casualty incident (MCI) triage is critical to prevent overwhelming trauma systems and reduce pediatric morbidity/mortality.
    • Existing MCI algorithms lack specific validation tools for the pediatric population.
    • There is a need for a validated tool to assess the accuracy of MCI triage algorithms in children.

    Purpose of the Study:

    • To develop a Criteria Outcomes Tool (COT) for validating MCI algorithms in pediatric trauma patients.
    • The COT aims to assess the accuracy of triage designations based on resource utilization and clinical outcomes.
    • To establish a reliable tool for the specific needs of pediatric mass casualty incidents.

    Main Methods:

    • Expert opinion and literature review were used to create an initial COT.
    • A modified-Delphi approach refined the COT, categorizing pediatric victims (≤14 years) using Red to Black designations.
    • The COT was validated through retrospective application to 25 pediatric trauma cases by two independent reviewers.

    Main Results:

    • A 47-item COT was created to validate MCI algorithm triage designations.
    • Application to 25 pediatric cases resulted in 6 Red, 6 Yellow, 6 Green, and 7 Black triage outcomes.
    • The tool demonstrated 100% inter-rater reliability between the two reviewers.

    Conclusions:

    • The developed Criteria Outcomes Tool (COT) effectively evaluates MCI algorithm performance in pediatric triage.
    • The COT shows good reproducibility, offering a valuable validation instrument for pediatric disaster scenarios.
    • This tool addresses a critical gap in pediatric emergency preparedness and response.