Triage Scheme in Disaster Emergency Essay Assignment Paper

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Triage Scheme in Disaster Emergency Essay Assignment Paper

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Question Description
I have to submit an annotation bibliography of 10 references within the upcoming two days. I should choose a topic about Triage scheme in disaster/Emergency management.

Use APA Style

Choose credible sources (peer-reviewed)

I attached some articles

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Accuracy of Prehospital Triage in Selecting Severely Injured Trauma Patients
Frank J. Voskens, MD; Eveline A. J. van Rein, BSc; Rogier van der Sluijs, BSc; Roderick M. Houwert, MD, PhD;
Robert Anton Lichtveld, MD, PhD; Egbert J. Verleisdonk, MD, PhD; Michiel Segers, MD; Ger van Olden, MD, PhD;
Marcel Dijkgraaf, PhD; Luke P. H. Leenen, MD, PhD; Mark van Heijl, MD, PhD

Adequate prehospital trauma triage of injured patients is imperative for optimal trauma care. In an inclusive trauma system, it is essential to transport patients
with severe injuries to a level I trauma center and patients without severe injuries to lower-level hospitals. 1,2 Previous
studies have clearly shown lower mortality rates in patients with severe injuries treated at a level I trauma center compared with patients treated at a lower-level hospitals.

Management of care of the injured trauma patient on
the scene of injury remains challenging, and situations can
be chaotic. After a rapid trauma assessment of clinical and
physiological parameters, emergency medical services
(EMS) professionals must identify patients at risk for severe
injury and select the proper destination. Prehospital triage
protocols are used to help define the patient destination.
However, triage of patients without evident abnormality
and instability at presentation remains challenging given
the limited facilities on scene.
In the Netherlands, allocation of trauma patients to the
appropriate level of trauma care is guided by the Dutch
Field Triage Protocol (version 7.1, National Protocol of
Ambulance Services),7 for EMS professionals (Figure 1). This
protocol is based on the Field Triage Decision Scheme established by the American College of Surgeons Committee on
Trauma (ACS-COT).8,9
Quality of prehospital triage can be determined by rates
of undertriage and overtriage. Undertriage is defined as the proportion of patients with severe injuries not transported to a

IMPORTANCE A major component of trauma care is adequate prehospital triage. To optimize
the prehospital triage system, it is essential to gain insight in the quality of prehospital triage
of the entire trauma system.
OBJECTIVE To prospectively evaluate the quality of the field triage system to identify severely
injured adult trauma patients.
DESIGN, SETTING, AND PARTICIPANTS Prehospital and hospital data of all adult trauma
patients during 2012 to 2014 transported with the highest priority by emergency medical
services professionals to 10 hospitals in Central Netherlands were prospectively collected.
Prehospital data collected by the emergency medical services professionals were matched to
hospital data collected in the trauma registry. An Injury Severity Score of 16 or more was used
to determine severe injury.
MAIN OUTCOMES AND MEASURES The quality and diagnostic accuracy of the field triage
protocol and compliance of emergency medical services professionals to the protocol.
RESULTS A total of 4950 trauma patients were evaluated of which 436 (8.8%) patients were
severely injured. The undertriage rate based on actual destination facility was 21.6% (95% CI,
18.0-25.7) with an overtriage rate of 30.6% (95% CI, 29.3-32.0). Analysis of the protocol
itself, regardless of destination facility, resulted in an undertriage of 63.8% (95% CI,
59.2-68.1) and overtriage of 7.4% (95% CI, 6.7-8.2). The compliance to the field triage trauma
protocol was 73% for patients with a level 1 indication.
CONCLUSIONS AND RELEVANCE More than 20% of the patients with severe injuries were not
transported to a level I trauma center. These patients are at risk for preventable morbidity and
mortality. This finding indicates the need for improvement of the prehospital triage protocol.

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