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Prehospital Response Time of the Emergency Medical Service during Mass Casualty Incidents and the Effect of Triage: A Retrospective Study

Published online by Cambridge University Press:  12 April 2021

Johan L. Heemskerk Open the ORCID record for Johan L. Heemskerk [Opens in a new window] ,
Kingsley O. Abode-Iyamah Open the ORCID record for Kingsley O. Abode-Iyamah [Opens in a new window] ,
Alfredo Quinones-Hinojosa Open the ORCID record for Alfredo Quinones-Hinojosa [Opens in a new window]  and
Eric S. Weinstein Open the ORCID record for Eric S. Weinstein [Opens in a new window]
Johan L. Heemskerk*
Affiliation:
Department of Neurological Surgery, Mayo Clinic, Jacksonville, USA Department of Orthopedic Surgery, OLVG Amsterdam, the Netherlands
Kingsley O. Abode-Iyamah
Affiliation:
Department of Neurological Surgery, Mayo Clinic, Jacksonville, USA
Alfredo Quinones-Hinojosa
Affiliation:
Department of Neurological Surgery, Mayo Clinic, Jacksonville, USA
Eric S. Weinstein
Affiliation:
CRIMEDIM Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Novara, Italy
*
Corresponding author: Johan L Heemskerk, Email: J.L.Heemskerk.MD@gmail.com.
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Abstract

Objective:

Prehospital time affects survival in trauma patients. Mass casualty incidents (MCIs) are overwhelming events where medical care exceeds available resources. This study aimed at evaluating the prehospital time during MCIs and investigating the effect of triage.

Methods:

A retrospective analysis was performed using Florida’s Event Medical Services Tracking and Reporting System database. All patients involved in MCIs during 2018 were accessed, and prehospital time intervals were evaluated and compared to that of non-MCIs. The effect of MCI triage and field triage (Field Triage Criteria) on prehospital time was evaluated.

Results:

In 2018, it was estimated that 2236 unique MCIs occurred in Florida, with a crude incidence of 10.1-10.9/100000 people. 2180 EMS units arrived at the hospital for patient disposition with a median alarm-to-hospital time of 43.74 minutes, significantly longer than non-MCIs (39.15 min; P < 0.001). MCI triage and field triage were both associated with shorter alarm-to-hospital time (39.37 min and 37.55 min, respectively).

Conclusions:

MCIs resulted in longer prehospital time intervals than non-MCIs. This finding suggests that additional efforts are needed to reduce the prehospital time for MCI patients. MCI triage and field triage were both associated with shorter alarm-to-hospital times. Widespread use may improve prehospital MCI care.

Keywords

emergency medical servicemass casualty incidentsprehospital timeMCI triagefield triage
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 3 , June 2022 , pp. 1091 - 1098
Copyright
© Society for Disaster Medicine and Public Health, Inc. 2021

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