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

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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.