title: Precision of in-hospital triage in mass-casualty incidents after terror attacks.
abstract: BACKGROUND
  Proper management of mass-casualty incidents (MCIs) relies on triage as a critical component of the disaster plan.
  
  
  OBJECTIVE
  [corrected] The objective of this study was to assess the precision of triage in mass-casualty incidents.
  
  
  METHODS
  The precision of decisions made by two experienced triage officers was examined in two large MCIs. These decisions were compared to the real severity of injury as defined by the Israeli Defence Forces (IDF) classification of severity of injuries and the Injury Severity Score (ISS).
  
  
  RESULTS
  Two experienced trauma physicians triaged a total of 94 casualties into 77 mild, seven moderate, and 10 severe casualties. Based on the IDF criteria, there were 74 mild, five moderate, and 15 severe casualties. Based on ISS scoring, there were 78 mild (ISS <9), five moderate (9 < or = ISS < 16), and 11 severe (ISS <16) casualties. Of 15 severely injured victims defined by the IDF classification of injury severity, the triage officers identified only seven (47%).
  
  
  CONCLUSIONS
  Primary triage, even when carried out by experienced trauma physicians, can be unreliable in a MCI.
authors.affiliation: Surgery B Department, Trauma Unit, Hillel Yaffe Medical Center, Hadera. adi_ita@hotmail.com
authors.forename: Itamar
authors.initials: I
authors.lastname: Ashkenazi
authors.forename: Boris
authors.initials: B
authors.lastname: Kessel
authors.forename: Tawfik
authors.initials: T
authors.lastname: Khashan
authors.forename: Jacob
authors.initials: J
authors.lastname: Haspel
authors.forename: Meir
authors.initials: M
authors.lastname: Oren
authors.forename: Oded
authors.initials: O
authors.lastname: Olsha
authors.forename: Ricardo
authors.initials: R
authors.lastname: Alfici
mesh_terms: D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000592:standards*; D006801:Humans; D007557:Israel; D015203:Reproducibility of Results; D012189:Retrospective Studies; D023481:Terrorism; D015599:Trauma Severity Indices; D014194:Traumatology / Q000592:standards*; D014218:Triage / Q000592:standards*; D014947:Wounds and Injuries / Q000145:classification*