Using clinical based vignettes to further develop a mass gathering event triage tool

Area of Science:

• Emergency Medicine
• Public Health
• Disaster Response

Background:

• Existing mass gathering event (MGE) triage tools lack real-world validation.
• Non-healthcare professionals often perform triage at MGEs.
• This study evaluated the decision-making consistency of an MGE triage tool.

Purpose of the Study:

• To determine the consistency of decision-making among non-healthcare professionals using a specific MGE triage tool.
• To assess the reliability of the triage tool in a simulated real-world MGE setting.

Main Methods:

• 110 volunteer members of St John Ambulance Australia participated.
• Participants completed surveys with demographic information and clinical vignettes.
• Triage categories were assigned based on vignettes and the provided tool.
• Statistical analysis included descriptive statistics and Fleiss Kappa for inter-rater reliability.

Main Results:

• A total of 110 participants, predominantly male (60%) and non-healthcare professionals (70%), were included.
• Overall agreement across vignettes was slightly better than moderate (p-bar: 0.55).
• Excellent agreement was observed for the resuscitation category (p-bar: 0.69), and moderate agreement for urgent (p-bar: 0.52) and minor (p-bar: 0.52) categories.

Conclusions:

• The study demonstrated decision-making consistency comparable to emergency department triage tools.
• Further multi-site, multi-type, real-world testing at MGEs is necessary to advance tool development.
• The findings support the potential utility of the evaluated triage tool for MGEs.