Triage decisions of Kocaeli 112 emergency health care providers, using a multiple casualty scenario

Abstract

Objectives: To examine the accuracy of theoretical triage decision making among 112 (911) emergency prehospital health care providers, using a multiple casualty paper exercise for triage. This study was conducted to determine future training requirements for prehospital care providers. Proper triage decisions are at the core of emergency medicine ethics and are required to commit ethical duties about the principles of justice, beneficence and “do no harm”.
Materials and Methods: A standardized 6 casualty paper exercise requiring each casualty to be prioritized for treatment was given to 64 prehospital emergency health care providers in Kocaeli. Each casualty was scored using the START algorithm. The scenario contained descriptions of an “immediate” casualty, two “urgent” casualties, two “non-urgent” casualties and a casualty regarded as “expectant”.
Results: We observed that triage training plays an important role in triage decision making. Generally, prehospital emergency health care providers were significantly more likely to over triage non-urgent and expectant cases. On the other hand, immediate and urgent cases were under triaged.
Conclusion: Participants who had prior triage training made the correct triage decisions significantly more (87.5%; 7) that those without training.. Triage training should be a regular part of prehospital provider education.