A novel laypeople mass-casualty assessment algorithm: LACA

Laypeople, usually the first on scene at a mass casualty event, still have no input into early operational tactics. A new and easy to learn algorithm done by laypeople might gain additional information for operational tactics, especially reinforcement.

A validated mass casualty data set was used to generate sets of 20 patients. The triage gold standard was compared to severity scores of different already established algorithms as well as the new invented allocation algorithm LACA. For algorithm quality Cronbach's Kappa, specificity, sensitivity, over- and underassessment was examined. Kullback-Leibler-Divergence was used to show information loss.

The LACA algorithm showed a moderate severity correlation (Cohen's Kappa = 0.469), lower than mSTaRT or PRIOR. PRIOR showed the already well known and intentional overassessment. LACA showed highest underassessment of all three evaluated algorithms. After adjustment the information loss could be reduced to D_KL = 0,0002 bits.

The "LACA" represents a practical and layperson-friendly addition to pre-hospital response strategies in mass casualty incidents. It can provide a reliable initial assessment that supports early operational decision-making. Additionally, this new approach enables emergency dispatch centers to perform a more tailored mobilization of rescue resources in the first place, based on the structured information provided by laypeople or lay responders. To maximize individual survival LACA must be followed by established triage algorithms like mSTaRT or PRIOR applied by trained emergency personnel.