Abstract
In a major incident, correct triage is crucial to emergency treatment and transportation
priority. The aim of this study was to evaluate the triage process pursued at the
site of the fire disaster in Volendam, the Netherlands on January 1, 2001. On-site
(OS) and Emergency Department (ED) data regarding total body surface area burned (TBSA)
and inhalation injury (INH) were compared with the final (FIN) assessment of these
two parameters after hospital admission. Finally, the effect of OS intubation and
the time of arrival at a hospital were evaluated. There were 245 injured. Mean age
was 17.3 years. Final median TBSA was 12%; 96 patients (39%) had inhalation injury.
Agreement between TBSA-OS (n = 46) and TBSA-FIN was poor (Pearson's correlations coefficient
[PCC] = 0.77; R2 = 0.60). TBSA-ED (n = 78) was more accurate (PCC = 0.96; R2 = 0.93). INH-OS (n = 79, sensitivity 100%, specificity 24%) and INH-ED (n = 198,
sensitivity 99%, specificity 36%) were sensitive but not specific. Eight patients
were intubated on-site. No differences in outcome were found between this group and
the patients who were intubated in the hospital. There was no difference in time of
arrival at a hospital (p = 0.55). TBSA was not estimated reliably in a non-clinical environment. The diagnosis
of inhalation injury was adequate but resulted in over-triage on-site and at the ED.
Triage did not lead to transport priorities for the severely wounded. In a major burn
accident, a field triage protocol for rapid evaluation of burn injuries may be useful.
Detailed assessment of injuries of burn casualties is practical only in a specialized
clinical setting.
Keywords
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Article info
Publication history
Published online: October 18, 2007
Accepted:
February 16,
2007
Received in revised form:
December 30,
2006
Received:
May 6,
2006
Footnotes
Financial support for this study was provided by the Ministry of Health, The Hague, The Netherlands.
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
