Application of a new resource-constrained triage method to military-age victims.
Objective: Evaluate the resource-constrained, evidence-based, and outcome-driven Sacco Triage method (STM) for military-age victims of blunt, penetrating, and blast overpressure-like trauma.Methods: STM is based on a mathematical model of resource-constrained triage. Its objective is to maximize exp...
| Published in: | Military Medicine Vol. 174; no. 12; pp. 1247 - 1256 |
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| Main Authors: | , , , , , |
| Format: | research Journal Article |
| Published: |
Oxford University Press / USA
Dec2009
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105279486&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105279486 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00264075 4DV jtl: Military Medicine issn: 00264075 maglogo: N pubinfo: dt: Dec2009 vid: 174 iid: 12 pid: 622 pub: Oxford University Press / USA artinfo: ui: 105279486 105279486 NLM20055064 2010521188 10.7205/milmed-d-04-1608 NLM20055064 105279486 ppf: 1247 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Application of a new resource-constrained triage method to military-age victims. aug: au: Navin DM Sacco WJ McGill G Navin, D Michael Sacco, William J McGill, Gill affil: ThinkSharp, Inc., 260 Gateway Drive, Suite 17-18C, Bel Air, MD 21014, USA sug: subj: Military Medicine Methods Models, Theoretical Triage Methods Wounds and Injuries Classification Wounds and Injuries Mortality Algorithms Delphi Technique Medical Practice, Evidence-Based Female Human Logistic Regression Male Outcomes (Health Care) Data Collection Survival Trauma Severity Indices Wounds and Injuries Therapy Female Male ab: Objective: Evaluate the resource-constrained, evidence-based, and outcome-driven Sacco Triage method (STM) for military-age victims of blunt, penetrating, and blast overpressure-like trauma.Methods: STM is based on a mathematical model of resource-constrained triage. Its objective is to maximize expected survivors given constraints on transport and treatment resources. STM uses estimates of time-dependent victim survival probabilities and expected deteriorations. A respiration, pulse, and best motor response (RPM) score predicts survivability. Logistic function-generated survival probability estimates from 99,369 military-age victims were assessed using calibration and discrimination statistics. The consensus building Delphi method was used to provide aggregate expert opinion on victim deterioration rates. The models were solved using linear programming. Rule-based (not requiring software) protocols were determined using a greedy algorithm for Iraqi combat scenarios, and simulations enabled comparison of STM to the widely known Simple Triage and Rapid Treatment (START) method.Results: RPM was an accurate predictor of survival probability, equivalent to the Revised Trauma Score and exceeding the Injury Severity Score. In 18 simulations, STM and STM rule-based protocols increased survivorship over START from 20% to an 18-fold increase.Conclusions: STM offers lifesaving and operational advantages for military-age victims of blunt, penetrating, and blast overpressure-like trauma. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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