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Triage and Clinical Evaluation in MCI

  • Yoram KleinEmail author
Chapter
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)

Abstract

Clinical evaluation is one of the fundamental elements of medicine. There are several factors in mass casualty incident (MCI) that make clinical evaluation more challenging. In the first phase of the management of the patient in MCI, all clinical evaluations should be done in a triage mode. That means, the diagnostic efforts should be focused on identifying immediate life-threatening conditions and quick decision about where the patient should be transferred to, in the next stage. The nature of the incidents allows very short time for these tasks. Another important aspect is the fact that in large-scale incidents the availability of ancillary diagnostic modalities is limited. Due to the anticipated discrepancy between number of patients and the availability of medical professionals from relevant specialty, many times less experienced caregivers, sometimes even from unrelated disciplines, are expected to evaluate and manage complicated trauma patients.

References

  1. 1.
    Robertson-Steel I. Evolution of triage systems. Emerg Med J. 2006;23(2):154–5.CrossRefGoogle Scholar
  2. 2.
    Kahn CA, Schultz CH, Miller KT, et al. Does START triage work? An outcomes assessment after a disaster. Ann Emerg Med. 2009;54(3):424–30.CrossRefGoogle Scholar
  3. 3.
    Arquilla B, Paladino L, Reich C, Brandler E, Lucchesi M, Shetty S. Using a joint triage model for multi-hospital response to a mass casualty incident in New York City. J Emerg Trauma Shock. 2009;2(2):114–6.CrossRefGoogle Scholar
  4. 4.
    Eastridge BJ, Mabry RL, Seguin P, et al. Death on the battlefield (2001–2011): implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S431–7.CrossRefGoogle Scholar
  5. 5.
    Dean MD, Nair SK. Mass-casualty triage: distribution of victims to multiple hospitals using the SAVE model. Eur J Oper Res. 2014;238(1):363–73.CrossRefGoogle Scholar
  6. 6.
    Bala M, Kaufman T, Keidar A, et al. Defining the need for blood and blood products transfusion following suicide bombing attacks on a civilian population: a level I single-centre experience. Injury. 2014;45:50–5.CrossRefGoogle Scholar
  7. 7.
    Hirshberg A, Stein M, Walden R. Surgical resource utilization in urban terrorist bombing: a computer simulation. J Trauma. 1999;47:545–50.CrossRefGoogle Scholar
  8. 8.
    Wydo SM, Seamon MJ, Melanson SW, Thomas P, Bahner DP, Stawicki SP. Portable ultrasound in disaster triage: a focused review. Eur J Trauma Emerg Surg. 2016;42(2):151–9. Epub 2015 Feb 11.CrossRefGoogle Scholar
  9. 9.
    Mueck FG, Wirth K, Muggenthaler M, Kreimeier U, Geyer L, Kanz KG, Linsenmaier U, Wirth S. Radiological mass casualty incident (MCI) workflow analysis: single-centre data of a mid-scale exercise. Br J Radiol. 2016;89:20150918.CrossRefGoogle Scholar
  10. 10.
    Kluger Y, Mayo A, Soffer D, Aladgem D, Halperin P. Functions and principles in the management of bombing mass casualty incidents: lessons learned at the Tel-Aviv Souraski Medical Center. Eur J Emerg Med. 2004;11:329–34.CrossRefGoogle Scholar
  11. 11.
    Lipsky AM, Klein Y, Givon A, Klein M, Hammond JS, Peleg K, Israeli Trauma Group (ITG). Accuracy of initial critical care triage decisions in blast versus non-blast trauma. Disaster Med Public Health Prep. 2014;8(4):326–32.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Trauma and Critical Care Division, Department of SurgerySheba Medical CenterRamat-GanIsrael

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