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Precision of In-Hospital Triage in Mass-Casualty Incidents after Terror Attacks

Published online by Cambridge University Press:  28 June 2012

Itamar Ashkenazi ,
Boris Kessel ,
Tawfik Khashan ,
Jacob Haspel ,
Meir Oren ,
Oded Olsha  and
Ricardo Alfici
Itamar Ashkenazi*
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
Boris Kessel
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
Tawfik Khashan
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
Jacob Haspel
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
Meir Oren
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
Oded Olsha
Affiliation:
Shaare Zedek Medical Center, Jerusalem, Israel
Ricardo Alfici
Affiliation:
Hillel Yaffe Medical Center, Hadera, Israel
*
Itamar Ashkenazi, MD Surgery B Department, Trauma Unit, Hillel Yaffe Medical Center, Hadera, POB 169, Israel 38100 E-mail: adi_ita@hotmail.com
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Abstract

Introduction:

Proper management of mass-casualty incidents (MCIs) relies on triage as a critical component of the disaster plan.

Objective:

The objective of this study was to assess the precision of triage in mass-casualty incidents.

Methods:

The precision of decisions made by two experienced triage officers was examined in two large MCIs. These decisions were compared to the real severity of injury as defined by the Israeli Defence Forces (IDF) classification of severity of injuries and the Injury Severity Score (ISS).

Results:

Two experienced trauma physicians triaged a total of 94 casualties into 77 mild, seven moderate, and 10 severe casualties. Based on the IDF criteria, there were 74 mild, five moderate, and 15 severe casualties. Based on ISS scoring, there were 78 mild (ISS <9), five moderate (9 ≤ISS<16), and 11 severe (ISS < 16) casualties. Of 15 severely injured victims defined by the IDF classification of injury severity, the triage officers identified only seven (47%).

Conclusion:

Primary triage, even when carried out by experienced trauma physicians, can be unreliable in a MCI.

Keywords

blast injurybomb injuriesmass-casualty incident (MCI)terrorismtriage
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 21 , Issue 1 , February 2006 , pp. 20 - 23
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2006

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