Abstract
Recently, initial preliminary triage by nonphysician emergency medical services (EMS) personnel during mass casualty incidents has been widely established in the German EMS system. Yet, many aspects of primary triage training and continuing education lack scientific evidence. To answer the question at which intervals retraining must be attended, we examined the triage ability of EMS personnel 1 ...
Abstract
Recently, initial preliminary triage by nonphysician emergency medical services (EMS) personnel during mass casualty incidents has been widely established in the German EMS system. Yet, many aspects of primary triage training and continuing education lack scientific evidence. To answer the question at which intervals retraining must be attended, we examined the triage ability of EMS personnel 1 year after primary triage certification. Participants of a previous evaluation study of the Amberg-Schwandorf algorithm for initial triage (ASAV) were asked to participate in this follow-up study. In teams of two, they triaged 20 dummy patients, whereby triage results, team performance, and time requirements were recorded. Results according to qualification and employment status (volunteer vs. professional staff) were analyzed as prespecified subgroups. In the second year after the triage training, the ability to perform the ASAV was markedly reduced in regard to triage accuracy (triage category, airway opening, and bleeding control), sensitivity, specificity, over- and under-triage, and general team performance. Time requirements remained unchanged. The triage competency of volunteer personnel was preserved much better compared to that of professional staff. The results indicate that in professional EMS systems, triage concepts should by retrained at 1 year intervals. Examinations for recertification without prior teaching do not seem to be promising. For volunteer organizations, longer retraining intervals could be considered. Applying triage principles more frequently in multiple patient scenarios below the mass casualty incident threshold could be a possibility to keep EMS providers in training.
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