START Triage: Improving a "tried-and-true" methodology.

描述（由申请人提供）：该项目旨在使用文献先验定义的标准，测量灾难或其他大规模伤亡事件现场患者分诊的准确性，并计算每个类别的敏感性和特异性。这将以涉及162名受害者的实际大规模伤亡事件来衡量，每个人都使用简单分诊和快速治疗（START）分诊方法（国防部和其他政府机构认可的标准，并在全球范围内使用）。其次，对每组分诊患者的现场时间和每组患者从现场到医院的平均距离进行测量并检查是否存在显著差异。长期目标是确定灾害患者分诊的国家标准是否符合可接受的准确性限制，并在可测量的结果方面表现得可接受，例如限制较严重受伤患者的现场时间和运输距离。然后，这些数据将用于改进当前的分诊方法，以改善灾害期间的患者护理、生存和资源利用。试点项目是在十多家医院以及当地紧急医疗服务机构使用一种前瞻性定义的数据收集工具进行图表审查。

DESCRIPTION (provided by the applicant): The project aims to measure the accuracy of patient triage at the scene of a disaster or other mass-casualty incident into each of three acuity categories using criteria defined a priori by the literature, and to calculate sensitivity and specificity for each category. This will be measured for an actual mass-casualty incident involving 162 victims, each triaged using the Simple Triage And Rapid Treatment (START) triage methodology (the standard recognized by the Department of Defense and other governmental agencies, and used worldwide). Secondarily, the time on scene for each group of triaged patients and the average distance from scene to hospital for each group will be measured and examined for significant differences. The long-term objective is to determine whether the national standard for disaster patient triage meets acceptable limits for accuracy and performs acceptably in measurable outcomes such as limiting time on scene and transport distance for more severely injured patients. These data will then be used to refine current triage methodology with the intent of improving patient care, survival, and resource utilization during disasters. The pilot project is a chart review at more than a dozen hospitals, as well as local Emergency Medical Services, using a prospectively defined data collection tool.