American journal of disaster medicine
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Determining pediatric severity of illness in referring centers may be useful for establishing appropriate patient disposition and interfacility transport. For this retrospective review, the authors evaluated the Canadian Paediatric Triage and Acuity Scale (PaedCTAS) tool in regards to individual patient disposition and outcomes. ⋯ A PaedCTAS assessment of 1 may be a reasonable predictor for PICU admissions and longer hospitalizations when calculated in referral centers at time of pediatric transport consultation. PaedCTAS assessments may provide useful adjuvant information for specialized pediatric transport programs.
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The objective of this study was to evaluate tourniquet use in the Hartford prehospital setting during a 34-month period after the Hartford Consensus was published, which encouraged increasing tourniquet use in light of military research. ⋯ Tourniquets are being used inappropriately in the Hartford prehospital setting. Misuse is associated with both EMTs and first responders, highlighting the need for better training and more consistent protocols.
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Comparative Study
Comparison of START and SALT triage methodologies to reference standard definitions and to a field mass casualty simulation.
We compared Sort, Assess, Lifesaving Intervention, Treatment/Transport (SALT) and Simple Triage and Rapid Treatment (START) triage methodologies to a published reference standard, and evaluated the accuracy of the START method applied by emergency medical services (EMS) personnel in a field simulation. ⋯ In our study, the SALT triage system was overall more accurate triage method than START at classi-fying patients, specifically in the delayed and immediate categories. In our field exercise, paramedic use of the START methodology yielded a higher rate of undertriage compared to the SALT classification.
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Disaster triage training for emergency medical service (EMS) providers is not standardized. Simulation training is costly and time-consuming. In contrast, educational video games enable low-cost and more time-efficient standardized training. We hypothesized that players of the video game "60 Seconds to Survival" (60S) would have greater improvements in disaster triage accuracy compared to control subjects who did not play 60S. ⋯ The intervention demonstrated a significant improvement in accuracy from baseline to time 2 while the control did not. However, there was no significant difference in the improvement between the intervention and control groups. These results may be due to small sample size. Future directions include assessment of the game's effect on triage accuracy with a larger, multisite site cohort and iterative development to improve 60S.