A review of the literature on the validity of mass casualty triage systems with a focus on chemical exposures.
A review of the literature on the validity of mass casualty triage systems with a focus on chemical exposures.
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DOI：
10.5055/ajdm.2014.0150
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发表时间：
2014-01-01
影响因子：
--
通讯作者：
Svendsen, Erik
中科院分区：
文献类型：
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作者：
Culley, Joan M;Svendsen, Erik
简介：大规模伤亡事件（MCI）包括自然（如地震）或人为（如恐怖主义或技术）事件。它们造成医疗需求和资源之间的不平衡，需要使用分诊战略。如果提供者要为最多的人做最大的好事，就必须准确有效地进行伤员分类。有有限的研究在确定优先照顾MCI的受害者，特别是那些涉及chemicals.Objective：目前的分类系统的有效性验证文献进行审查，以分配现场治疗状态代码的大规模伤亡的受害者，特别是那些涉及化学品，使用实际的病人的结果。这篇文章的重点是一个系统的文献综述，描述了影响的MCI，特别是那些涉及化学品，对目前的分诊系统有关的现场分配的治疗状态代码的受害者和验证分配的代码使用实际的病人的结果。结果：有广泛的文献发表的分类系统用于MCI，但只有四篇文章使用实际结果数据来验证大规模伤亡分类结果，包括三个化学事件。目前，收集的数据的数量和类型是不一致的或标准化和定义是不universal.CONCLUSIONS：目前的文献没有提供必要的证据，特别是那些涉及化学品的MCI的分流系统的有效性。需要精心设计的研究来验证用于MCI（包括涉及化学品的系统）的分类系统的可靠性、灵敏度和特异性。
INTRODUCTION: Mass casualty incidents (MCIs) include natural (eg, earthquake) or human (eg, terrorism or technical) events. They produce an imbalance between medical needs and resources necessitating the use of triage strategies. Triage of casualties must be performed accurately and efficiently if providers are to do the greatest good for the greatest number. There is limited research on the validation of triage system efficacy in determining the priority of care for victims of MCI, particularly those involving chemicals.OBJECTIVE: To review the literature on the validation of current triage systems to assign on-site treatment status codes to victims of mass casualties, particularly those involving chemicals, using actual patient outcomes.METHODS: The focus of this article is a systematic review of the literature to describe the influences of MCIs, particularly those involving chemicals, on current triage systems related to the on-site assignment of treatment status codes to a victim and the validation of the assigned code using actual patient outcomes.RESULTS: There is extensive literature published on triage systems used for MCI but only four articles used actual outcome data to validate mass casualty triage outcomes including three for chemical events. Currently, the amount and type of data collected are not consistent or standardized and definitions are not universal.CONCLUSIONS: Current literature does not provide needed evidence on the validity of triage systems for MCI in particular those involving chemicals. Well designed studies are needed to validate the reliability, sensitivity, and specificity of triage systems used for MCI including those involving chemicals.