Ambulance service team leaders may be required to provide organisational leadership at complex incidents, such as a mass-casualty incident involving triage sieve. It may be expected that team leaders have a greater understanding of, and should be able to better apply their skills, than their team members during such an incident. The objective of this study was to determine if team leaders have a higher theoretical knowledge and better triage sieve application skills than their team members.
Team leaders were allotted into one of two groups: the first (control) group completed a questionnaire without any supporting documentation (ie. aide-memoir), whereas the second (intervention) group completed the same questionnaire, as the control group, but utilising supportive documentation.
The results show that the team leaders from the control group achieved significantly better results than their team members when completing a questionnaire, without the use of supportive documentation. There was no significant difference between team leaders from the intervention group and their team members when completing the same questionnaire using supportive documentation.
It has been shown that the use of printed supportive material in the form of an aide-memoir decreases the knowledge and application gap between team leaders and their team members, and increases triage sieve accuracy. The results from this study reinforces the results from previous studies, showing that supporting documentation should be used to ensure greater triage sieve accuracy rates and thereby reducing under- and over-triage rates.
Government A. Australian Emergency Management Glossary. In: Department AG, editor, Canberra: Commonwealth of Australia; 1998.
Arshad FH, Williams A, Asaeda G, et al. A modified simple triage and rapid treatment algorithm from the New York City (USA) Fire Department. Prehosp Disaster Med 2015;30:199-204.
Cross KP, Petry MJ, Cicero MX. A better START for low-acuity victims: data-driven refinement of mass casualty triage. Prehosp Emerg Care 2015;19:272-8.
Benson M, Koenig KL, Schultz CH. Disaster triage: START, then SAVE-a new method of dynamic triage for victims of a catastrophic earthquake. Prehosp Disaster Med 1996;11:117-24.
Jenkins JL, McCarthy ML, Sauer LM, et al. Mass-casualty triage: time for an evidence-based approach. ibid. 2008;23:3-8.
Unit NHEM. Mass casualty triage - smart triage packs. In: Health N, editor. Sydney: NSW Government; 2017. p. 9.
Group ALS. Major incident medical management and support : the practical approach in the hospital. Hoboken: Wiley; 2008. Available at: http://flinders.eblib.com/patron/FullRecord.aspx?p=351256
Lee CW, McLeod SL, Peddle MB. First responder accuracy using SALT after brief initial training. Prehosp Disaster Med 2015;1-5.
Lerner EB, Schwartz RB, Coule PL, et al. Mass casualty triage: an evaluation of the data and development of a proposed national guideline. Disaster Med Public Health Prep 2008;2(Suppl 1):S25-34.
Armstrong JH, Frykberg ER, Burris DG. Toward a national standard in primary mass casualty triage. ibid. 2008;2(Suppl 1):S8-10.
Field K, Norton I. Australian triage tags: a prospective, randomised cross-over trial and evaluation of user preference. Emerg Med Australas 2012;24:321-8.
Aitken P, FitzGerald G. Disaster triage: evidence, consistency and standard practice. ibid. 2012;24:222-4.
Nocera A, Garner A. An Australian mass casualty incident triage system for the future based upon triage mistakes of the past: the Homebush Triage Standard. Aust N Z J Surg 1999;69:603-8.
Garner A, Nocera A. 'Sieve', 'sort' or START. Emerg Med 2001;13:477.
Cuttance G, Dansie K, Rayner T. Paramedic application of a triage sieve: a paper-based exercise. Prehosp Disaster Med 2017;1-11.
Kilner T. Triage decisions of prehospital emergency health care providers, using a multiple casualty scenario paper exercise. Emerg Med J 2002;19:348-53.
Kilner T, Hall FJ. Triage decisions of United Kingdom police firearms officers using a multiple-casualty scenario paper exercise. Prehosp Disaster Med 2005;20:40-6.
Aylwin CJ, Konig TC, Brennan NW, et al. Reduction in critical mortality in urban mass casualty incidents: analysis of triage, surge, and resource use after the London bombings on July 7, 2005. Lancet 2006;368:2219-25.
Challen K, Walter D. Major incident triage: comparative validation using data from 7th July bombings. Injury 2013;44:629-33.
Sasser SM, Hunt RC, Faul M, et al. Guidelines for field triage of injured patients: recommendations of the National Expert Panel on Field Triage, 2011. MMWR 2012;61:1-20.
Lee AC, Phillips W, Challen K, Goodacre S. Emergency management in health: key issues and challenges in the UK. BMC Public Health 2012;12:884.
Australia GoS. State emergency management plan. South Australia: SA Police; 2015.
Alenyo AN, Smith WP, McCaul M, Van Hoving DJ. A comparison between differently skilled prehospital emergency care providers in major-incident triage in South Africa. Prehosp Disaster Med 2018;1-6.