Documentation and tagging of casualties in multiple casualty incidents.

The use of triage tags is widely advocated as a tool to improve the management of multiple casualty incident scenes. However, there are no published reports to suggest that triage tags have improved the management of incidents involving more than 24 persons, and a number of reports have detailed problems associated with triage tag use. Alternative systems of scene management such as geographical triage have been successfully used in very large incidents, and are recommended as an alternative to triage tags. Documentation cards attached to casualties may be of use in situations where casualties will pass through an extended evacuation chain, and clear labels for deceased casualties are of benefit as they discourage repeat assessments. Adoption of an evidence-based approach to multiple casualty incident scene management will require a paradigm shift in the thinking of ambulance services. A broad-based educational approach that encourages critical reappraisal of existing procedures is recommended.

[1]  W. Rutherford.  Experience in the accident and emergency department of the Royal Victoria Hospital with patients from civil disturbances in Belfast 1969-1972, with a review of disasters in the United Kingdom 1951-1971. , 1973, Injury.

[2]  M L Cowan,et al.  New concepts in triage. , 1986, Annals of emergency medicine.

[3]  K. L. Stevens,et al.  The Clapham rail disaster. , 1990, Injury.

[4]  A Nocera,et al.  An Australian mass casualty incident triage system for the future based upon triage mistakes of the past: the Homebush Triage Standard. , 1999, The Australian and New Zealand journal of surgery.

[5]  Paul B. Anderson,et al.  EMS Response to a Major Aircraft Incident: Sioux City, Iowa , 1990 .

[6]  Macdonald Ag.  Sorting out triage in urban disasters. , 1985 .

[7]  P E Pepe,et al.  Field management and critical care in mass disasters. , 1991, Critical care clinics.

[8]  F. Burkle,et al.  Health care personnel in disaster response. Reversible roles or territorial imperatives? , 1996, Emergency medicine clinics of North America.

[9]  D Barton,et al.  Assessment of a triage label system during a major incident exercise. , 1991, Prehospital and disaster medicine.

[10]  C. Spengler.  The Oklahoma City Bombing: A Personal Account , 1995, Journal of child neurology.

[11]  S M Orr,et al.  The Hyatt Regency skywalk collapse: an EMS-based disaster response. , 1983, Annals of emergency medicine.

[12]  T. Hodgetts.  Lessons from the Musgrave Park Hospital bombing. , 1993, Injury.

[13]  S. Koka,et al.  Inferior (subacromial) dislocation of the outer end of the clavicle. , 1993, Injury.

[14]  A Nocera,et al.  Australian disaster triage: a colour maze in the Tower of Babel. , 1999, The Australian and New Zealand journal of surgery.

[15]  P. Paris,et al.  The Three Rivers Regatta accident: an EMS perspective. , 1991, The American journal of emergency medicine.

[16]  S. Beyersdorf,et al.  Community medical response to the Fairchild mass casualty event. , 1996, American journal of surgery.

[17]  M. Demars,et al.  Victim-tracking cards in a community disaster drill. , 1980, Annals of emergency medicine.

[18]  R. Coupland,et al.  Triage of war wounded: the experience of the International Committee of the Red Cross. , 1992, Injury.