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First Responder Accuracy Using SALT during Mass-casualty Incident Simulation.

Christopher W C Lee1, Shelley L McLeod1, Kristine Van Aarsen1

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

Prehospital and Disaster Medicine
|February 10, 2016
PubMed
Summary

Primary care paramedic and fire science students showed similar mass-casualty incident triage times and error types after brief Sort, Assess, Life-saving interventions, Treatment/Transport (SALT) training. Paramedics had slightly higher accuracy, but the difference was minimal.

Keywords:
AssessEMS Emergency Medical ServicesEmergency Medical ServicesFS fire scienceLSI life-saving interventionLife-saving interventionsMCI mass-casualty incidentPCP primary care paramedicSALT SortSTART Simple Triage and Rapid TreatmentTreatment/Transportfire and rescue personnelmass-casualty incidentstriage

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Area of Science:

  • Emergency Medicine
  • Disaster Response
  • Paramedic Education

Background:

  • Mass-casualty incidents (MCIs) often overwhelm Emergency Medical Services (EMS) resources.
  • Accurate triage by first responders is crucial for efficient patient management and resource allocation.
  • Investigating triage capabilities of different responder groups can optimize prehospital care during MCIs.

Purpose of the Study:

  • To compare triage accuracy, error patterns, and completion time between primary care paramedic (PCP) and fire science (FS) students using the Sort, Assess, Life-saving interventions, Treatment/Transport (SALT) algorithm in a simulated MCI.
  • To determine if FS students can effectively perform MCI triage with brief training.

Main Methods:

  • Second-year PCP and FS students received a 30-minute didactic session on the SALT triage algorithm.
  • Participants triaged a standardized eight-victim mock MCI scenario.
  • Triage accuracy, error types (over-triage, under-triage, critical errors), and time to completion were recorded.

Main Results:

  • Overall triage accuracy was 79.9% for PCP students and 72.0% for FS students (p=0.03).
  • No significant differences were found in the types of triage errors or time to triage completion between the two groups.
  • Error rates included over-triage (10.2% PCP, 15.2% FS), under-triage (7.6% PCP, 8.7% FS), and critical errors (2.3% PCP, 4.3% FS).

Conclusions:

  • While PCPs demonstrated slightly higher overall triage accuracy, the minimal clinical difference suggests FS personnel can be trained for MCI triage.
  • Training in the SALT algorithm is effective for both PCP and FS students in a simulated MCI.
  • Fire services personnel could be integrated into MCI triage roles, contingent on appropriate training and resource availability.