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

ip between overtriage and critical patient mortality is not linear, and is highly dependent on whether there is a surplus or shortage of trauma bays in regional emergency departments.

"In some cases -- for example, when the risk of death over the short term is high but you have a really large capacity to care for the injured -- we can now show how overtriage may actually be a good thing, because you get more people into emergency care than you would otherwise," Dr. Hupert says. "On the other hand, if you have a more limited capacity, overtriage can be much less valuable, and perhaps harmful."

The model also addresses another relative unknown in mass casualty response: the impact of large numbers of "walk-in" patients on outcomes of those most critically injured. As with overtriage, the model suggests that the "walking wounded" can have a variable impact on the relationship between resources and mortality. By giving planners the ability to quantify these effects, however, the model advances the current state of disaster response logistics.

The bottom line, according to the researchers, is that the "best" triage strategy during a mass casualty event is probably one that takes into account a variety of local and regional factors, which means that use of the model should spur regional collaboration and information sharing. "We hope that this type of modeling study will be used to help disaster response teams plan effective strategies to deal with mass casualty events occurring in their own specific regions," Dr. Hupert says. "We can never predict when or where disaster will strike, but with models like these we can hope to be more prepared."

Now that they have a better understanding of the relationship between triage and outcomes, the researchers are continuing to build the model. "In our current work, we are incorporating details such as the spectrum of likely injuries from a particular event, the diagnostic tests needed to sort
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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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