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.
Ersoy
Nermin
N
Department of History of Medicine & Medical Ethics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
Akpinar
Aslihan
A
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