Pre-hospital triage performance after standardized trauma courses

Area of Science:

• Emergency Medicine
• Trauma Care
• Disaster Preparedness

Background:

• Pre-hospital triage is critical for identifying and prioritizing patients needing immediate intervention.
• Mass Casualty Incident (MCI) drills are essential for evaluating emergency response.
• This study assessed triage decision-making skills in MCI scenarios.

Purpose of the Study:

• To evaluate and compare triage decision-making skills between Advanced Trauma Life Support (ATLS) and Pre-Hospital Trauma Life Support (PHTLS) course participants.
• To determine the impact of ATLS and PHTLS courses on triage skills in a simulated MCI.

Main Methods:

• A questionnaire assessed decision-making, casualty prioritization, and evacuation prioritization in a simulated bus crash MCI.
• Participants from ATLS and PHTLS courses completed the questionnaire pre- and post-course.
• 153 ATLS and 175 PHTLS participants were analyzed with 90% and 95% response rates, respectively.

Main Results:

• PHTLS participants showed a significant improvement in decision-making post-course (p=0.04), but only if they had prior MCI drill or real-event experience.
• No significant improvement in casualty prioritization or identification of critically injured patients for evacuation was observed in either group.
• ATLS participants did not demonstrate significant improvement in any tested triage skill.

Conclusions:

• Current ATLS and PHTLS courses do not generally enhance tested triage skills.
• Prior experience with Mass Casualty Incidents positively impacts PHTLS participants' decision-making.
• ATLS and PHTLS training programs require modification to effectively improve essential triage skills.