In the aftermath of tragedy: Medical and psychiatric consequences

  • Drury J
  • Cocking C
  • Reicher S
 et al. 
  • 13


    Mendeley users who have this article in their library.
  • N/A


    Citations of this article.


UNLABELLED Introduction During mass-casualty incidents (MCIs), patient volume often overwhelms available Emergency Medical Services (EMS) personnel. First responders are expected to triage, treat, and transport patients in a timely fashion. If other responders could triage accurately, prehospital EMS resources could be focused more directly on patients that require immediate medical attention and transport. Hypothesis Triage accuracy, error patterns, and time to triage completion are similar between second-year primary care paramedic (PCP) and fire science (FS) students participating in a simulated MCI using the Sort, Assess, Life-saving interventions, Treatment/Transport (SALT) triage algorithm. METHODS All students in the second-year PCP program and FS program at two separate community colleges were invited to participate in this study. Immediately following a 30-minute didactic session on SALT, participants were given a standardized briefing and asked to triage an eight-victim, mock MCI using SALT. The scenario consisted of a four-car motor vehicle collision with each victim portrayed by volunteer actors given appropriate moulage and symptom coaching for their pattern of injury. The total number and acuity of victims were unknown to participants prior to arrival to the mock scenario. RESULTS Thirty-eight PCP and 29 FS students completed the simulation. Overall triage accuracy was 79.9% for PCP and 72.0% for FS (∆ 7.9%; 95% CI, 1.2-14.7) students. No significant difference was found between the groups regarding types of triage errors. Over-triage, under-triage, and critical errors occurred in 10.2%, 7.6%, and 2.3% of PCP triage assignments, respectively. Fire science students had a similar pattern with 15.2% over-triaged, 8.7% under-triaged, and 4.3% critical errors. The median [IQR] time to triage completion for PCPs and FSs were 142.1 [52.6] seconds and 159.0 [40.5] seconds, respectively (P=.19; Mann-Whitney Test). CONCLUSIONS Primary care paramedics performed MCI triage more accurately than FS students after brief SALT training, but no difference was found regarding types of error or time to triage completion. The clinical importance of this difference in triage accuracy likely is minimal, suggesting that fire services personnel could be considered for MCI triage depending on the availability of prehospital medical resources and appropriate training. Lee CWC , McLeod SL , Van Aarsen K , Klingel M , Franc JM , Peddle MB . First responder accuracy using SALT during mass-casualty incident simulation. Prehosp Disaster Med. 2016;31(2):150-154.

Author-supplied keywords

  • 0451 Psychology
  • 2009
  • Assess
  • Attitude to Death*
  • Awareness*
  • Behaviour
  • Bus crash
  • CBRN
  • Clinical
  • Compassionate care
  • Consequences
  • Death
  • Decision-making
  • Disaster
  • Disaster Planning
  • Disaster Planning: standards
  • EMS Emergency Medical Services
  • Emergency Medical Services
  • Emergency Nursing
  • Emergency Nursing: standards
  • Emergency medical services
  • Emergency nursing
  • Emergency response
  • Emotions*
  • Evacuation modelling
  • Experiences
  • FS fire science
  • Female
  • First responders
  • Human factors
  • Human patient simulator
  • Humans
  • Interview
  • Interviews
  • LSI life-saving intervention
  • Life-saving interventions
  • MCI mass-casualty incident
  • Male
  • Mass casualty
  • New York City
  • PCP primary care paramedic
  • Practice Guidelines as Topic
  • Pre-evacuation behaviour
  • Protection motivation theory
  • Qualitative content analysis
  • Qualitative research
  • Random utility model
  • Risk perception and communication
  • SALT Sort
  • START Simple Triage and Rapid Treatment
  • September 11 Terrorist Attacks*
  • Social 0622 Psychology
  • Social support
  • Spirituality*
  • Suicide
  • Treatment/Transport
  • Triage
  • Triage: methods
  • Triage: standards
  • Trust
  • Virtual reality
  • Wounds and Injuries
  • Wounds and Injuries: nursing
  • Wounds and Injuries: therapy
  • against two per-
  • at a
  • but sacrificed
  • bystander effect
  • bystander intervention
  • dangerous emergencies
  • dominik brunner was murdered
  • fire and rescue personnel
  • german train station after
  • he has not chosen
  • he helped little children
  • helping
  • mass-casualty incidents
  • meta-analysis
  • on the 12th september
  • petrators
  • to look the other
  • triage
  • way

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in


  • John Drury

  • Chris Cocking

  • Steve Reicher

  • Peter Fischer

  • Joachim I Krueger

  • Tobias Greitemeyer

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free