Use and analysis of field triage criteria for mass gatherings.
BACKGROUND
Mass gatherings may result in an acute increase in the number of people seeking medical care potentially causing undue stress to local emergency medical services (EMS) and hospitals. Often, temporary medical facilities are established within the mass gathering venue. Emergency Medical Services providers encountering patients in the field should be equipped with effective protocols to determine transport destination (venue facility vs. hospital).


OBJECTIVE
Paramedics are capable of appropriately using triage criteria written specifically for a particular mass gathering. The use of triage criteria, when applied correctly, decreases over-triage to the venue facility and undertriage to the hospital.


METHODS
Paramedics triaged patients at a mass gathering to a temporary venue facility or to a single emergency department using criteria specific for the event. Cases were reviewed to determine if the patients transported went to an appropriate facility and if the triage criteria were applied appropriately.


RESULTS
Transport destination was consistent with that dictated by the criteria for 78% of cases. Analysis of these cases shows that the criteria had a sensitivity of 100% (95% CI = 58-100%) and a specificity of 90% (95% CI = 73-98%) for predicting which patients needed hospital services and which could be cared for safely in the temporary clinic setting.


CONCLUSIONS
Triage by paramedics at the point of patient contact may reduce transporting of patients to hospitals unnecessarily. Patients in need of hospital services were identified. Point-of-contact triage should be applied in mass gatherings.
Division of Emergency Medicine, Children's Hospital, Boston, Massachusetts 02115, USA. steven.salhanick@childrens.harvard.edu
Steven D
SD
Salhanick
William
W
Sheahan
Jeffrey J
JJ
Bazarian
D000293:Adolescent; D001265:Athletic Injuries / Q000175:diagnosis*; D004634:Emergency Medical Technicians; D005260:Female; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D014187:Transportation of Patients; D014218:Triage