title: Qualitative Analysis of Surveyed Emergency Responders and the Identified Factors That Affect First Stage of Primary Triage Decision-Making of Mass Casualty Incidents.
abstract: BACKGROUND
  After all large-scale disasters multiple papers are published describing the shortcomings of the triage methods utilized. This paper uses medical provider input to help describe attributes and patient characteristics that impact triage decisions.
  
  
  METHODS
  A survey distributed electronically to medical providers with and without disaster experience. Questions asked included what disaster experiences they had, and to rank six attributes in order of importance regarding triage.
  
  
  RESULTS
  403 unique completed surveys were analyzed. 92% practiced a structural triage approach with the rest reporting they used "gestalt".(gut feeling) Twelve per cent were identified as having placed patients in an expectant category during triage. Respiratory status, ability to speak, perfusion/pulse were all ranked in the top three. Gut feeling regardless of statistical analysis was fourth. Supplies were ranked in the top four when analyzed for those who had placed patients in the expectant category.
  
  
  CONCLUSIONS
  Primary triage decisions in a mass casualty scenario are multifactorial and encompass patient mobility, life saving interventions, situational instincts, and logistics.
authors.affiliation: UT Southwestern Medical Center at Dallas.
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Klein
authors.affiliation: Harvard Humanitarian Initiative, Harvard University, Cambridge, MA, USA.
authors.forename: Frederick M
authors.initials: FM
authors.lastname: Burkle
authors.affiliation: University of Texas Southwestern Medical Center.
authors.forename: Raymond
authors.initials: R
authors.lastname: Swienton
authors.affiliation: University of Texas Southwestern Medical Center University of Texas Southwestern Medical Center.
authors.forename: Richard V
authors.initials: RV
authors.lastname: King
authors.affiliation: Co-Director National Training Center-West NDLS Foundation.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehman
authors.affiliation: Professor The Altshler Center for Education & Research at Metrocare Services and The University of Texas Southwestern Medical Center, Department of Psychiatry.
authors.forename: Carol S
authors.initials: CS
authors.lastname: North
keywords: Disaster medicine; Emergency management; Mass casualty care; Triage