Triaging patients prior to the arrival of the mass casualty: Emergency Severity Index equivalency to SALT disaster triage

Authors

DOI:

https://doi.org/10.5055/ajdm.2022.0426

Keywords:

disaster medicine, disaster planning, disasters, Mass Casualty Incidents, triage

Abstract

Objective: To compare the Emergency Severity Index (ESI) and Sort Assess Life Saving Interventions Treatment and Transport (SALT) triage categories for an existing emergency department (ED) patient population.

Design: A prospective, cross-sectional study.

Setting: An academic-affiliated community teaching ED at a Level 1 Trauma Center.

Participants: All patients presenting to the ED over 2 nonconsecutive 24-hour weekdays.

Main outcome measures: The correlation between triage system classifications was assessed using the Spearman’s rank correlation coefficient.

Results: 100 percent of ESI 5, 83.3 percent of ESI 4, and 70.4 percent of ESI 3 were categorized as Minimal under SALT. 70.8 percent of ESI 2 was categorized as Delayed, and 71.4 percent of ESI 1 designations correlated with Immediate. Spearman’s rank correlation coefficient was 0.509 (p < 0.001).

Conclusion: This study results suggest that ESI moderately correlates with SALT, particularly in lower acuity patients. This result may inform future protocol development for rapid triage of existing ED populations prior to the arrival of patients from a mass casualty event.

Author Biographies

Bryan J. Wexler, MD, MPH

Department of Emergency Medicine, Wellspan York Hospital, York, Pennsylvania

Barbara A. Stahlman, MS

Department of Emergency Medicine, Wellspan York Hospital, York, Pennsylvania

References

Gilboy N, Tanabe P, Travers DA, et al.: Emergency Severity Index Version 4: Implementation Handbook. Rockville, MD: Agency for Healthcare Research and Quality, 2012.

Lerner EB, Schwartz RB, Coule PL, et al.: Mass casualty triage: An evaluation of the data and development of a proposed national guideline. Disaster Med Public Health Prep. 2008; 2(Suppl. 1): S25-S34.

SALT mass casualty triage: Concept endorsed by the American College of Emergency Physicians, American College of Surgeons Committee on Trauma, American Trauma Society, National Association of EMS Physicians, National Disaster Life Support Education Consortium, and State and Territorial Injury Prevention Directors Association. Disaster Med Public Health Prep. 2008; 2(4): 245-246.

Hong R, Sexton R, Sweet B, et al.: Comparison of START triage categories to emergency department triage levels to determine need for urgent care and to predict hospitalization. Am J Disaster Med. 2015; 10(1): 13-21.

Morton MJ, DeAugustinis ML, Velasquez CA, et al.: Developments in surge research priorities: A systematic review of the literature following the Academic Emergency Medicine Consensus Conference, 2007-2015. Acad Emerg Med. 2015; 22(11): 1235-1252.

Faul F, Erdfelder E, Buchner A, et al.: G*power version 3.1.2 [computer software]. Uiversität Kiel. Germany. 2008. Available at http://www.psycho.uni-duesseldorf.de/abteilungen/aap/gpower3/download-and-register. Accessed February 8, 2021.

Published

04/01/2022

How to Cite

Wexler, MD, MPH, B. J., and B. A. Stahlman, MS. “Triaging Patients Prior to the Arrival of the Mass Casualty: Emergency Severity Index Equivalency to SALT Disaster Triage”. American Journal of Disaster Medicine, vol. 17, no. 2, Apr. 2022, pp. 127-30, doi:10.5055/ajdm.2022.0426.

Issue

Section

Articles

Similar Articles

You may also start an advanced similarity search for this article.