Triage during the week of the Sichuan earthquake: a review of utilized patient triage, care, and disposition procedures.
OBJECTIVE
There exists no standard hospital emergency department (ED) triage procedure model for earthquake victims. This study provides an overview of the hospital triage procedure used for patients evaluated and treated at the West China Hospital of Sichuan University, Chengdu in the Sichuan province of China, following the May 12, 2008 Wenchuan earthquake.


METHODS
Emergency triage and treatment teams were comprised of senior emergency medicine (EM) attending physician, junior EM attending physician, EM residents, and specialty surgeons. Retrospective analysis of the hospital medical records of 2283 earthquake victims was performed. Victims' demographic data, triage process and group assignments, diagnoses and dispositions were reviewed.


RESULTS
In the 2 weeks following the Wenchuan earthquake, 2283 total patients with earthquake-related injuries were admitted to our hospital. 54 victims (2.4%) were lost to follow up. Patients were triaged into four main groups: resuscitation (n=6), urgent treatment (n=369), delayed treatment (n=1502), and minor injuries (n=406). 68.9% (1572/2283) of the patients were admitted to the hospital during the 15 days after the earthquake. The overall hospital mortality rate was 1.0% (15/1572). 1304 victims were transferred to nearby hospitals after initial treatment, stabilization, or surgery.


CONCLUSIONS
Proper triage strategy should be established prior to the onset of a mass casualty event and should be appropriate to both the severity of the disaster and the accepting facility resource availability. Triage methods utilizing multi-specialty treatment teams and dynamic hospital-wide coordination are critical for efficient, efficacious patient management. Hopefully, sharing with the emergency medicine community the arduous challenges we faced in the wake of the Wenchuan earthquake will be useful for planning the response to future disasters.
Department of Emergency Medicine, West China Hospital, Sichuan University, 37 GuoXueXiang, Cheng-Du, People's Republic of China.
Hu
H
Nie
Shi-Yuan
SY
Tang
Wayne Bond
WB
Lau
Jian-Cheng
JC
Zhang
Yao-Wen
YW
Jiang
Bernard L
BL
Lopez
Xin L
XL
Ma
Yu
Y
Cao
Theodore A
TA
Christopher
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004189:Disaster Planning / Q000458:organization & administration* / Q000592:standards; D055866:Earthquakes / Q000401:mortality / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D054527:Mass Casualty Incidents; D008875:Middle Aged; D012189:Retrospective Studies; D014218:Triage / Q000458:organization & administration* / Q000592:standards; D055815:Young Adult