Citation

Vassallo J, Smith JE, Bruijns SR, Wallis LA. Injury 2016; 47(9): 1898-1902.

Affiliation

Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.

Copyright

(Copyright © 2016, Elsevier Publishing)

DOI

10.1016/j.injury.2016.06.022

PMID

27375012

Abstract

INTRODUCTION: Triage is a key principle in the effective management of major incidents. The process currently relies on algorithms assigning patients to specific triage categories; there is, however, little guidance as to what these categories represent. Previously, these algorithms were validated against injury severity scores, but it is accepted now that the need for life-saving intervention is a more important outcome. However, the definition of a life-saving intervention is unclear. The aim of this study was to define what constitutes a life-saving intervention, in order to facilitate the definition of an adult priority one patient during the definitive care phase of a major incident.

METHODS: We conducted a modified Delphi study, using a panel of subject matter experts drawn from the United Kingdom and Republic of South Africa with a background in Emergency Care or Major Incident Management. The study was conducted using an online survey tool, over three rounds between July and December 2013. A four point Likert scale was used to seek consensus for 50 possible interventions, with a consensus level set at 70%.

RESULTS: 24 participants completed all three rounds of the Delphi, with 32 life-saving interventions reaching consensus.

CONCLUSIONS: This study provides a consensus definition of what constitutes a life-saving intervention in the context of an adult, priority one patient during the definitive care phase of a major incident. The definition will contribute to further research into major incident triage, specifically in terms of validation of an adult major incident triage tool.

Copyright © 2016 Elsevier Ltd. All rights reserved.

Language: en