Facilitating the Reverse Triage Selection Process: A European Delphi.

Area of Science:

• Emergency Medicine
• Disaster Management
• Healthcare Policy

Background:

• Reverse triage is crucial in Mass Casualty Incidents (MCI) and crowding.
• Standardized terminology and criteria for reverse triage are lacking in Europe.
• A clear framework is needed to guide patient disposition during overwhelming events.

Purpose of the Study:

• To achieve European consensus on reverse triage terminology, criteria, and cutoffs.
• To develop a standardized Patient Disposition Classification Model (PDCM).
• To establish clear guidelines for managing patient flow in MCI and crowding.

Main Methods:

• An e-Delphi study with a two-part design was conducted.
• Part 1 involved developing a theoretical framework for the PDCM.
• Part 2 included a European expert panel review, consensus on critical interventions, and risk tolerance assignment.

Main Results:

• A 5-category PDCM was established.
• A universal list of 18 critical interventions for MCI and crowding was defined.
• Upper limits of acceptable risk for Consequential Medical Events (CME) were assigned to each PDCM category.

Conclusions:

• The Delphi study successfully established European consensus on reverse triage.
• Standardized terminology, criteria, and cutoffs for reverse triage in MCI and crowding were achieved.
• The developed PDCM provides a framework for consistent patient disposition during emergencies.