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Triage by Resource Allocation for INpatients: A Novel Disaster Triage Tool for Hospitalized Pediatric Patients

Anna Lin1, Kristine Taylor2, Ronald S Cohen3

  • 11Division of Pediatric Hospital Medicine,Stanford University,Office of Emergency Management,Lucile Packard Children's Hospital Stanford.

Disaster Medicine and Public Health Preparedness
|February 1, 2018
PubMed

Insights

A new disaster triage tool effectively categorizes pediatric patients for hospital evacuation. This tool significantly improves the efficiency of determining transport needs during emergencies, outperforming traditional methods.

Area of Science:

  • Disaster medicine
  • Pediatric emergency care
  • Healthcare management

Background:

  • Hospital evacuation planning is critical for patient safety during disasters.
  • Existing triage tools may not adequately address the specific needs of pediatric populations.
  • Efficient resource allocation is paramount during mass casualty incidents.

Purpose of the Study:

  • To develop and refine a disaster triage tool for evacuating hospitalized neonatal and pediatric patients.
  • To enhance the efficiency of assessing and communicating patient transport needs during emergencies.

Main Methods:

  • Expansion of an existing neonatal disaster triage tool for a children's hospital.
  • Bedside visual assessments and chart reviews to categorize patient transport levels.
  • Utilized Plan-Do-Study-Act cycles for tool refinement and validated against local EMS protocols and expert opinion.

Main Results:

  • Evaluated 1382 patients over 10 days, achieving 96.3% concordance between visual assessment and electronic chart review.
  • During a statewide drill, a single nurse used the Triage by Resource Allocation in INpatients (TRAIN) tool to determine transport needs in under 1 hour.
  • No hospital units self-assessed transport needs, highlighting the tool's effectiveness.

Conclusions:

  • The developed disaster triage tool is effective for pediatric hospital evacuations.
  • The TRAIN tool significantly improves the efficiency of determining patient transport needs compared to traditional methods.
  • This tool can enhance preparedness and response for pediatric mass casualty events.
Abstract

Keywords:
disaster planninghospital evacuationpediatricsurge capacitytriage

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