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Disaster Triage Systems for Large-scale Catastrophic Events

Published online by Cambridge University Press:  08 April 2013

Nathan A. Bostick ,
Italo Subbarao ,
Frederick M. Burkle Jr ,
Edbert B. Hsu ,
John H. Armstrong  and
James J. James
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Abstract

Large-scale catastrophic events typically result in a scarcity of essential medical resources and accordingly necessitate the implementation of triage management policies to minimize preventable morbidity and mortality. Accomplishing this goal requires a reconceptualization of triage as a population-based systemic process that integrates care at all points of interaction between patients and the health care system. This system identifies at minimum 4 orders of contact: first order, the community; second order, prehospital; third order, facility; and fourth order, regional level. Adopting this approach will ensure that disaster response activities will occur in a comprehensive fashion that minimizes the patient care burden at each subsequent order of intervention and reduces the overall need to ration care. The seamless integration of all orders of intervention within this systems-based model of disaster-specific triage, coordinated through health emergency operations centers, can ensure that disaster response measures are undertaken in a manner that is effective, just, and equitable. (Disaster Med Public Health Preparedness. 2008;2(Suppl 1):S35–S39)

Keywords

triagelarge-scale catastrophesresponse measures
Type
Special Focus
Information
Disaster Medicine and Public Health Preparedness , Volume 2 , Issue S1 , September 2008 , pp. S35 - S39
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2008

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References

REFERENCES

1.Bell, NK.Triage in medical practices: an unacceptable model. Soc Sci Med. 1981;15:151–156.Google ScholarPubMed
2. World Medical Association. World Medical Association Statement on Medical Ethics in the Event of Disasters. September 2006. http://www.wma.net/e/policy/d7.html. Accessed July 31, 2008.Google Scholar
3.Burkle, FM.Population-based triage management in response to surge-capacity requirements during a large scale bioevent disaster. Acad Emerg Med. 2006;13:11118–11229.Google ScholarPubMed
4.Larkin, GL, Arnold, J.Ethical considerations in emergency planning, preparedness, and response to acts of terrorism. Prehosp Disaster Med. 2003;18:170–178.CrossRefGoogle ScholarPubMed
5.Domres, B, Koch, M, Manger, A, et alEthics and triage. Prehosp Disaster Med. 2001;16:53–57.CrossRefGoogle ScholarPubMed
6.Eisenman, DP, Cordasco, KM, Asch, S, et alDisaster planning and risk communication with vulnerable communities: lessons from Hurricane Katrina. Am J Public Health. 2007;97 suppl 1S109–S115.CrossRefGoogle ScholarPubMed
7.Beard, L, Clark, C.SARS: a health system's perspective. Hosp Q. 2003;6:55–58.Google ScholarPubMed
8.McGuire, LC, Ford, ES, Okoro, CA.Natural disasters and older US adults with disabilities: implications for evacuation. Disasters. 2007;31:49–56.CrossRefGoogle ScholarPubMed
9.Laditka, SB, Laditka, JN, Xirasagar, S, et alProviding shelter to nursing home evacuees in disasters: lessons from Hurricane Katrina. Am J Public Health. 2008;98:1288–1293.CrossRefGoogle ScholarPubMed
10.START Triage Web site. http://www.start-triage.com. Accessed June 2, 2008.Google Scholar
11.Romig, LE.Pediatric Triage. A system to JumpSTART your triage of young patients at MCIs. JEMS. 2002;27:52–53.Google ScholarPubMed
12.Benson, M, Koenig, KL, Schultz, CH.Disaster triage: START, then SAVE—a new method of dynamic triage for victims of a catastrophic earthquake. Prehosp Disaster Med. 1996;11:117–124.CrossRefGoogle ScholarPubMed
13.Hogetts, TJ, Mackway-Jones, K.Major Incident Medical Management and Support: The Practical Approach. London: BMJ Publishing; 1995.Google Scholar
14.Sacco, WJ, Navin, DM, Fiedler, KE, et alPrecise formulation and evidence-based application of resource-constrained triage. Acad Emerg Med. 2005;12:759–770.Google ScholarPubMed
15.Frickberg, EF.Principles of mass casualty management following terrorist disasters. Ann Surg. 2004;239:319–321.CrossRefGoogle Scholar
16.Almogy, G, Belzberg, H, Mintz, Y, et alSuicide bombing attacks: update and modifications to the protocol. Ann Surg. 2004;239:295–303.CrossRefGoogle ScholarPubMed
17.Rubinson, L, Hick, JL, Hanfling, DG, et alDefinitive care for the critically ill during a disaster: a framework for optimizing critical care surge capacity. Chest. 2008;133:18–31.CrossRefGoogle ScholarPubMed
18.Davis, DP, Post, JC, Hicks, T, et alHospital bed surge capacity in the event of a mass-casualty event. Prehosp Disaster Med. 2005;20:253–261.CrossRefGoogle Scholar
19.Hick, JL, Hanfling, D, Burstein, JL, et alHealth care facility and community strategies for patient care surge capacity. Ann Emerg Med. 2004;44:253–261.CrossRefGoogle ScholarPubMed
20.Shultz, CH, Koenig, KL, Lewis, RJ.Implications of hospital evacuation after the Northbridge, California, earthquake. N Engl J Med. 2003;348:1349–1355.CrossRefGoogle Scholar
21.Winslow, GR.Triage and Justice. Los Angeles: University of California Press; 1992.Google Scholar
22.Powell, T, Christ, KC, Birkhead, GS.Allocation of ventilators in a public health disaster. Disaster Med Public Health Preparedness. 2008;2:20–26.CrossRefGoogle Scholar
23.Burkle, FM, Hsu, EB, Loehr, M, et alDefinition and functions of health unified command and emergency operations centers for large-scale bioevent disasters within the existing ICS. Disaster Med Public Health Prep. 2007;1:135–141.CrossRefGoogle ScholarPubMed
24. Motef J. Critical Infrastructure Protections: The 9/11 Commission Report and Congressional Response. http://fas.org/sgp/crs/homesec/RL32531.pdf. Accessed June 3, 2008.Google Scholar
25.Rubinson, L, Hick, JL, Hanfling, DG, et alSummary of suggestions from the task force for mass critical care summit, January 26–27, 2007. Chest. 2008;133:1–7.Google Scholar
26.Auf der Heide, E.The importance of evidence-based disaster planning. Ann Emer Med. 2006;47:34–49.CrossRefGoogle ScholarPubMed
27.Jenkins, JL, McCarthy, ML, Sauer, LM, et alMass-casualty triage: time for an evidence-based approach. Prehosp Disaster Med. 2008;23:3–8.CrossRefGoogle ScholarPubMed
28.Gostin, LO, Powers, M.What does social justice require for the public's health? Public health ethics and policy imperatives. Health Aff. 2006;25:1053–1060.CrossRefGoogle ScholarPubMed
29.Trotter, G.The Ethics of Coercion in Mass Casualty Medicine. Baltimore: The Johns Hopkins University Press; 2007.CrossRefGoogle Scholar
30.Clabresi, G, Bobbit, P.Tragic Choices. New York: WW Norton; 1978.Google Scholar
31.Gostin, LO.Public Health Law: Power, Duty, Restraint. Berkeley: University of California Press; 2000.Google Scholar