Triage decisions of emergency physicians in Kocaeli and the principle of justice.
BACKGROUND
We aimed to examine the accuracy of triage decision-making among emergency physicians, using a multiple casualty scenario. This will assist in determining the necessity of triage training, which is the foundation of emergency medical ethics.


METHODS
A self-administered questionnaire including a multiple casualty scenario requiring each casualty to be prioritized for treatments by Simple Triage and Rapid Treatment (START) was given to 110 emergency physicians working at pre-hospital and hospital emergency services in Kocaeli. The differences between personal/professional characteristics and triage decisions were analyzed using chi-square test.


RESULTS
Accurate triage decision rates of the emergency physicians ranged from 83.6% to 90.0% for four immediate casualties, 26.4% to 78.2% for seven urgent casualties, 70.9% to 91.8% for four delayed casualties, and 82.7% to 97.3% for two dead cases. Personal and professional characteristics were found to be statistically significant in five cases (p<0.05).


CONCLUSIONS
This study showed that emergency physicians tended to under-triage patients. This result and the discrepancy of the accuracy rates in urgent casualties revealed the necessity for improvement in medical-ethical decision-making in the training programs. This improvement will help in reducing violation of the important duties of justice and of do no harm by the emergency physicians.
Department of History of Medicine & Medical Ethics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
Nermin
N
Ersoy
Aslihan
A
Akpinar
D003657:Decision Making; D004189:Disaster Planning; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006801:Humans; D010820:Physicians; D012935:Social Justice; D014218:Triage; D014421:Turkey