Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-23T18:44:32.034Z Has data issue: false hasContentIssue false
  • English
  • Français

Precision of In-Hospital Triage in Mass-Casualty Incidents after Terror Attacks

Published online by Cambridge University Press:  28 June 2012

Itamar Ashkenazi ,
Boris Kessel ,
Tawfik Khashan ,
Jacob Haspel ,
Meir Oren ,
Oded Olsha  and
Ricardo Alfici
Itamar Ashkenazi*
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
Boris Kessel
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
Tawfik Khashan
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
Jacob Haspel
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
Meir Oren
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
Oded Olsha
Affiliation:
Shaare Zedek Medical Center, Jerusalem, Israel
Ricardo Alfici
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
*
Itamar Ashkenazi, MD Surgery B Department, Trauma Unit, Hillel Yaffe Medical Center, Hadera, POB 169, Israel 38100 E-mail: adi_ita@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Proper management of mass-casualty incidents (MCIs) relies on triage as a critical component of the disaster plan.

Objective:

The objective of this study was to assess the precision of triage in mass-casualty incidents.

Methods:

The precision of decisions made by two experienced triage officers was examined in two large MCIs. These decisions were compared to the real severity of injury as defined by the Israeli Defence Forces (IDF) classification of severity of injuries and the Injury Severity Score (ISS).

Results:

Two experienced trauma physicians triaged a total of 94 casualties into 77 mild, seven moderate, and 10 severe casualties. Based on the IDF criteria, there were 74 mild, five moderate, and 15 severe casualties. Based on ISS scoring, there were 78 mild (ISS <9), five moderate (9 ≤ISS<16), and 11 severe (ISS < 16) casualties. Of 15 severely injured victims defined by the IDF classification of injury severity, the triage officers identified only seven (47%).

Conclusion:

Primary triage, even when carried out by experienced trauma physicians, can be unreliable in a MCI.

Keywords

blast injurybomb injuriesmass-casualty incident (MCI)terrorismtriage
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 21 , Issue 1 , February 2006 , pp. 20 - 23
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Zimmerman, JM: Mass Casualty Management. In: Ballinger, WF, Rutherford, WF, Zudeima, OD (eds), The Management of Trauma. WB Saunders Co., 1968, pp 778–782.Google Scholar
2.Hirshberg, A, Holocomb, JB, Mattox, KL: Hospital trauma care in multiplecasualty incidents: A critical view. Ann Emerg Med 2001;37(6):647–652.CrossRefGoogle ScholarPubMed
3.Frykberg, ER, Tepas, JJ: Terrorist bombings: Lessons learned from Belfast to Beirut. Ann Surg 1988;208(5):569–576.CrossRefGoogle ScholarPubMed
4.Shapira, S: Blast Injuries. In: Trauma. Letter. Israel Defence Forces Medical Corps, April 1993:1–15.Google Scholar
5.Champion, HR, Sacco, WJ, Copes WS:Trauma Scoring. In: More, EE, Mattox, KL, Feliciano, DV (eds): Trauma 2nd ed., Norwalk Connecticut: Appleton & Lange, 1991, pp 47–65.Google Scholar
6.Frykberg, ER: Medical management of disasters and mass casualties from terrorist bombings: How can we cope? J Trauma 2002;53(2):201–212.CrossRefGoogle ScholarPubMed
7.Kluger, Y, Peleg, K, Daniel-Aharonson, L, Mayo, A, The Israeli Trauma Group: The special injury pattern in terrorist bombings. J Am Coll Surg 2004:199(6):875–879.CrossRefGoogle Scholar
8.Garner, A, Lee, A, Harrison, K, Schultz, CH: Comparative analysis of multiplecasualty incident triage algorithms. Ann Emerg Med 2001;38(5):541–548.CrossRefGoogle ScholarPubMed
9.Halpern, P, Tsai, M-C, Arnold, JL, Stock, E, Ersoy, G: Mass-casualty terrorist bombings: Implications for emergency department and hospital response (Part II). Prehosp Disast Med 2003;18(3):235–241.CrossRefGoogle ScholarPubMed
10.Almogy, G, Belzberg, H, Mintz, Y, Pikarsky, AK, Zamir, G, Rivkind, AI: Suicide bombing attacks, updates and modifications to the protocol. Ann Surg 2004;239:2095–2303.CrossRefGoogle ScholarPubMed