Triage and management of mass casualties in a train accident.
OBJECTIVE
The purpose of this study was to assess the practicality and usefulness of different scoring systems of triage process in mass casualty management.


METHODS
Descriptive/observational.


METHODS
An experience of management of train accident in Balochistan in the year 2003.


METHODS
One hundred and twenty-two patients injured in train accident of Quetta Express were included in the study. A trauma team reached the site of the accident. Triage was done at three levels. "Triage sieve" scoring system was used at the site of accident, "field categories of trauma patients" at Primary Health Care Centre, and "ATLS (Advanced Trauma Life Support) secondary survey" at tertiary referral centre. Helicopters and ambulances were used for evacuation of patients.


RESULTS
There were 122 injured patients. " Triage sieve " system scored 14(11.47%) patients in priority I, 21(17.21%) patients in priority II, 80(65.57%) patients in priority III and 7(5.73%) dead individuals in priority IV at the site of accident. Casualties clearing time was three and half hours. By utilizing "field categories of trauma patients" at primary health care centre, 7(5.7%) patients were placed in category I who were air lifted, 19(15.57%) patients in category II, 89(72.95%) patients in category III and 7(5.73%) dead remained in category IV. Application of ATLS secondary survey in CMH, Quetta triaged 4(57.14) patients in priority I and 3(42.85) patients in priority II. There was only one death after the triage process started.


CONCLUSIONS
Proper triage, appropriate resuscitation, and timely evacuation definitively decrease morbidity and mortality in trauma patients, and facilitates utilization of the available resources appropriately.
Malik
Zaka Ullah
ZU
Department of Orthopaedic, Combined Military Hospital, Quetta. zumalik58@hotmail.com
Pervez
Muhammad
M
Safdar
Aqeel
A
Masood
Tahir
T
Tariq
Muhammad
M
D000059:Accidents; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D011890:Railroads; D018635:Rescue Work; D015599:Trauma Severity Indices; D014218:Triage; D014947:Wounds and Injuries / Q000145:classification / Q000628:therapy*