@article{ref1,
title="Comparing the accuracy of mass casualty triage systems when used in an adult population",
journal="Prehospital emergency care",
year="2019",
author="McKee, Courtney H. and Heffernan, Robert W. and Willenbring, Brian W. and Schwartz, Richard B. and Liu, J. Marc and Colella, M. Riccardo and Lerner, E. Brooke",
volume="ePub",
number="ePub",
pages="1-8",
abstract="<b>Objective.</b> To use a previously published criterion standard to compare the accuracy of four different mass casualty triage systems (SALT, START, Triage Sieve, and CareFlight) when used in an emergency department-based adult population. <b>Methods.</b> We performed a prospective, observational study of a convenience sample of adults aged 18 years or older presenting to a single tertiary care hospital emergency department. A co-investigator with prior EMS experience observed each subject's initial triage in the emergency department and recorded all data points necessary to assign a triage category using each of the four mass casualty triage systems being studied. Subjects' medical records were reviewed after their discharge from the hospital to assign the &quot;correct&quot; triage category using the criterion standard. The four mass casualty triage system assignments were then compared to the &quot;correct&quot; assignment. Descriptive statistics were used to compare accuracy and over- and under-triage rates for each triage system. <b>Results.</b> 125 subjects were included in the study. Of those, 53% were male and 59% were transported by private vehicle. When compared to the criterion standard definitions, SALT was found to have the highest accuracy rate (52%; 95% CI 43-60) compared to START (36%; 95% CI 28-44), CareFlight (36%; 95% CI 28-44), and TriageSieve (37%; 95% CI 28-45). SALT also had the lowest under-triage rate (26%; 95% CI 19-34) compared to START (57%; 95% CI 48-66), CareFlight (58%; 95% CI 49-66), and TriageSieve (58%; 95% CI 49-66). SALT had the highest over-triage rate (22%; 95% CI 14-30) compared to START (7%; 95% CI 3-12), CareFlight (6%; 95% CI 2-11) and TriageSieve (6%; 95% CI 2-10). <b>Conclusion.</b> We found that SALT triage most often correctly triaged adult emergency department patients when compared to a previously published criterion standard. While there are no target under- and over-triage rates that have been published for mass casualty triage, all four systems had relatively high rates of under-triage.<p /> <p>Language: en</p>",
language="en",
issn="1090-3127",
doi="10.1080/10903127.2019.1641579",
url="http://dx.doi.org/10.1080/10903127.2019.1641579"
}