Summary:
Objective: Description of the features of the field triage algorithms for
paediatric population (age range 0-18 years), a review and their comparison and
assessment.
Study Design: A registration attempt of incidents with mass paediatric
casualties in international level during the last 40 years gives an answer to
the need for triage algorithms for special populations. A number of field
pediatric triage algorithms in a prehospital phase, during MCEs is being
presented.
Results: Description and comparison of 9 in total, field triage algorithms,
specially designed for children, or, and for children, during mass casualties
events: R-START, Jump-START, Sieve, Paediatric Triage Tape, Careflight, STM-
Sacco Triage Method, Israeli Paediatric Triage System, MASS- Move, Assess, Sort
and Send and Paediatric Assessment Triangle. Validity studies of the triage
algorithms are being reviewed.
Conclusions: The relatively restricted number of incidents and the missing data
demonstrate the need for an index related data base. The data inserted will be
related not only to the disasters’ nature but also to the victim’s identity and
their wounds. This registration index will assign to the representation of a
Casualty Incident Profile / CIP contributing to the best evaluation of the
health consequences to special populations and imposing a related corresponding
scheme.
The choice of the most appropriate field triage tool has to take in
consideration a large number of parameters among them the victim’s age. The
multiplicity of field triage systems during MCEs for victims with age range
from 0 to 18 years designates a consensus lack, an issue which would be
probably have serious implications to an incidents’ management procedure. The
fastest and best correspondence to a health related incident will be assured by
the implementation of a commonly accepted standardized triage algorithm for
paediatric victims which will be also validated and inter- rater reliable,
applicable to any kind of incident.
Due to limitations in issues of ethics, which not allow the validation of the
triage algorithms in real events, specially designed exercises could contribute
to their validation and their inter rater reliability. A tabletop exercise for
that purpose is presented.
Keywords:
Paediatric triage , Interrater reliability , Tabletop exercise , MCE
