Impact of a Two-step Emergency Department Triage Model with START, then CTAS, on XXXX Flow During a Simulated Mass-casualty Incident.

@entity1 @entity3928 @entity341
UNASSIGNED: Introduction A high influx of @entity1 during a @entity3928 ( @entity3928 ) may disrupt @entity1 flow in an already overcrowded @entity341 ( @entity341 ) that is functioning beyond its operating capacity. This pilot study examined the impact of a two-step @entity341 triage model using Simple Triage and Rapid Treatment (START) for pre-triage, followed by triage with the Canadian Triage and Acuity Scale (CTAS), on @entity1 flow during a @entity3928 simulation exercise. Hypothesis/Problem It was hypothesized that there would be no difference in time intervals nor @entity1 volumes at each @entity1 -flow milestone. METHODS: Physicians and nurses participated in a computer-based tabletop disaster simulation exercise. Physicians were randomized into the intervention group using START, then CTAS, or the control group using START alone. @entity1 -flow milestones including time intervals and @entity1 volumes from @entity341 arrival to triage, @entity341 arrival to bed assignment, @entity341 arrival to physician assessment, and @entity341 arrival to disposition decision were compared. Triage accuracy was compared for secondary purposes. RESULTS: There were no significant differences in the time interval from @entity341 arrival to triage (mean difference 108 seconds; 95% CI, -353 to 596 seconds; P=1.0), @entity341 arrival to bed assignment (mean difference 362 seconds; 95% CI, -1,269 to 545 seconds; P=1.0), @entity341 arrival to physician assessment (mean difference 31 seconds; 95% CI, -1,104 to 348 seconds; P=0.92), and @entity341 arrival to disposition decision (mean difference 175 seconds; 95% CI, -1,650 to 1,300 seconds; P=1.0) between the two groups. There were no significant differences in the volume of @entity1 to be triaged (32% vs 34%; 95% CI for the difference -16% to 21%; P=1.0), assigned a bed (16% vs 21%; 95% CI for the difference -11% to 20%; P=1.0), assessed by a physician (20% vs 22%; 95% CI for the difference -14% to 19%; P=1.0), and with a disposition decision (20% vs 9%; 95% CI for the difference -25% to 4%; P=.34) between the two groups. The accuracy of triage was similar in both groups (57% vs 70%; 95% CI for the difference -15% to 41%; P=.46). CONCLUSION: Experienced triage nurses were able to apply CTAS effectively during a @entity3928 simulation exercise. A two-step @entity341 triage model using START, then CTAS, had similar @entity1 flow and triage accuracy when compared to START alone. Lee JS , Franc JM . Impact of a two-step @entity341 triage model with START, then CTAS, on @entity1 flow during a simulated @entity3928 . Prehosp Disaster Med. 2015;30(4):1-7.
