Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-18T11:17:04.709Z Has data issue: false hasContentIssue false
  • English
  • Français

Use and Analysis of Field Triage Criteria for Mass Gatherings

Published online by Cambridge University Press:  28 June 2012

Steven D. Salhanick ,
William Sheahan  and
Jeffrey J. Bazarian
Steven D. Salhanick*
Affiliation:
Program in Toxicology, Children's Hospital, Boston, Massachusetts USA
William Sheahan
Affiliation:
Emergency Medical Services Coordinator, Livingston County, New York USA
Jeffrey J. Bazarian
Affiliation:
Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York USA
*
Program in Toxicology, Division of Emergency Medicine, Children's Hospital, Boston, I. C. Smith Building, 300 Longwood Avenue, Boston, MA 02115 USA, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Mass gatherings may result in an acute increase in the number of people seeking medical care potentially causing undue stress to local emergencymedical services (EMS) and hospitals. Often, temporary medical facilities are established within the mass gathering venue. Emergency Medical Services providers encountering patients in the field should be equipped with effective protocols to determine transport destination (venue facility vs. hospital).

Hypothesis:

Paramedics are capable of appropriately using triage criteria written specifically for a particular mass gathering. The use of triage criteria, when appliedcorrectly, decreases over-triage to the venue facility and under-triage to the hospital.

Methods:

Paramedics triaged patients at a mass gathering to a temporary venue facility or to a single emergency department using criteria specific for the event. Cases were reviewed to determine if the patients transported went to an appropriate facility and if the triage criteria were applied appropriately. Results: Transport destination was consistent with that dictated by the criteria for 78% of cases. Analysis of these cases shows that the criteria had a sensitivity of 100% (95% CI = 58–100%) and a specificity of 90% (95% CI = 73–98%) for predicting which patients needed hospital services and which could be cared for safely in the temporary clinic setting.

Conclusions:

Triage by paramedics at the point of patient contact may reduce transporting of patients to hospitals unnecessarily. Patients in need of hospital services were identified. Point-of-contact triage should be applied in mass gatherings.

Keywords

emergency servicesmass gatheringparamedicprehospitaltriage
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 18 , Issue 4 , December 2003 , pp. 347 - 352
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Sanders, AB, Criss, E, Steckl, P, Meislin, HW, Raife, J, Allen, D: An analysis of medical care at mass gatherings. Ann Emerg Med 1986;15(5):515–519.CrossRefGoogle ScholarPubMed
2. Leonard, RB: Medical Support for Mass Gatherings. Emerg Med Clin North Am 1996;14(2):383–397.CrossRefGoogle ScholarPubMed
3. Suy, K, Gijsenbergh, F, Baute, L: Emergency medical assistance during a mass gathering. Eur J Emerg Med 1999;6(3):249–254.CrossRefGoogle ScholarPubMed
4. Derlet, RW, Richards, JR: Overcrowding in the nation's emergency departments: Complex causes and disturbing effects. Ann Emerg Med 2000;53(1): 63–68.CrossRefGoogle Scholar
5. Nordberg, M: EMS and Mass Gatherings. Emerg Med Services 1990;19:46. (Abstract)Google ScholarPubMed
6. Friedman, LJ, Rodi, SW, Krueger, MA, Votey, SR: Medical care at the California AIDS Ride 3: Experiences in event medicine. Ann Emerg Med 1998;31(2):219–223.CrossRefGoogle ScholarPubMed
7. Motalto, NJ, Janas, TB: Medical coverage of recreational cycling events. Clin Sports Med 1994;13(1):249–258.CrossRefGoogle Scholar
8. Gannon, DM, Derse, AR, Bronkema, PJ, Primley, DM: The emergency care network of a ski marathon. Am J Sports Med 1985;13(5):316–320.CrossRefGoogle ScholarPubMed
9. Laird, RH: Medicalcare at ultraendurance triathalons. Med Sci Sports and Exerc. 1989;21(5 Suppl):S222–225.CrossRefGoogle Scholar
10. Whipkey, RR, Paris, PM, Stewart, RD: Emergency care for mass gatherings. Postgrad Med 1984;76(2):44–54.CrossRefGoogle ScholarPubMed
11. Scmidt, TA, Atcheson, R, Federiuk, C, Mann, NC, Pinney, T, Fuller, D, Colbry, K: Hospital follow-up of patients categorized as not needing an ambulance using a set of emergency medical technician protocols. Prehosp Emerg Care 2001;5(4):366–370.Google Scholar
12. Schaefer, RA, Rea, TD, Plorde, M, Peiguss, K, Goldberg, P, Murray, JA: An emergency medical services program of alternate destination of patient care. Prehosp Emerg Care 2002;6(3):309–314.CrossRefGoogle ScholarPubMed
13. Silvestri, S, Rothrock, SG, Kennedy, D, Ladde, J, Bryant, M, Pagane, J: Can paramedics accurately identify patients who do not require emergency department care? Prehosp Emerg Care 2002;6(4):387–390.CrossRefGoogle Scholar
14. Pointer, JE, Levitt, MA, Young, JC, Promes, SB, Messana, BJ, Ader, MEJ: Can paramedicsusing guidelines accurately triage patients? Ann Emerg Med 2001;38(3):268–277.CrossRefGoogle ScholarPubMed