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Triage study challenges notions of emergency medical response to disaster
Date:1/3/2008

count local resources and response times, as well as specific types of mass casualty events."

The study is published in a special October supplement on mass casualty incidents of the journal Disaster Medicine and Public Health Preparedness, which focuses on the Virginia Tech shooting.

According to Dr. Hupert, experts in the field of traumatology and disaster preparedness have tended to rely on historical or anecdotal evidence to describe the downside of overtriage. "A number of studies released over the past decade have bolstered the notion that overtriage stretches limited medical resources during mass casualty events and ends up costing lives," Dr. Hupert says. "This was thought to happen in a linear fashion: More overtriage, more unnecessary deaths."

Overtriage can be valuable, however, because it helps ensure that critically injured people who do require speedy, lifesaving care aren't missed. In fact, guidelines from the American College of Surgeons support a limited amount of overtriage in emergency care.

To determine how much overtriage matters to patient outcomes, Dr. Hupert, along with engineers Eric Hollingsworth and Dr. Wei Xiong, Instructor in the Department of Public Health, created a discrete event simulation model representing the size and type of mass casualty event, the accuracy of field triage, and the treatment capability of the regional hospital trauma system. The model included a number of key variables that had never been brought together in one unified framework.

"We included the ability of responders to triage patients, either in the field or at the site of care; the capacity of local centers to care for incoming wounded and then recycle resources to care for new patients; the time needed to process and treat patients; and the window of time in which it was assumed critically injured patients might die," Hollingsworth explains.

The team found that, contrary to prior reports, the relationsh
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Contact: Emily Berlanstein
eab2007@med.cornell.edu
212-821-0560
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College
Source:Eurekalert

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