Is Overtriage Associated With Increased Mortality? The Evidence Says “Yes”

Examining the effect of overtriage on critical mortality, Hupert and colleagues have modeled triage as a diagnostic test that gives a result of critical or noncritical to casualties in sequence; this result then leads to prioritized resource utilization.1 The model emphasizes trauma system capabilit...

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Bibliographic Details
Published in:Disaster medicine and public health preparedness 2008-03, Vol.2 (1), p.4-5
Main Authors: Armstrong, John H., Hammond, Jeffrey, Hirshberg, Asher, Frykberg, Erik R.
Format: Article
Language:English
Subjects:
Critical Care - organization & administration
Disaster Medicine
Disasters
Emergency medical services
Emergency preparedness
Evidence-Based Medicine
Humans
Models, Theoretical
Mortality
Mortality - trends
Planning
Public health
Trauma
Triage - organization & administration
United States
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Summary:Examining the effect of overtriage on critical mortality, Hupert and colleagues have modeled triage as a diagnostic test that gives a result of critical or noncritical to casualties in sequence; this result then leads to prioritized resource utilization.1 The model emphasizes trauma system capability, rather than individual hospital capability. The model of Hupert et al deviates from the real-life experience of trauma systems dealing with mass casualty incidents in three important respects: it assumes an orderly sequential flow of casualties, which almost never occurs in real mass casualty incidents2; it links the trauma bay in the emergency department with an operating room, even though only a small minority of critical casualties in a real MCI require surgery3; and it uses the START triage algorithm that is mostly applicable to field situations and almost irrelevant to triage at the hospital door. Insights from a simulation model of mass casualty trauma care, Disaster Med Public Health Preparedness. 2007; 1:
ISSN:1935-7893
1938-744X
DOI:10.1097/DMP.0b013e31816476c0