From Chaos to Order: Evaluating a Mobile Triage System for Mass Casualty Incidents Through a Within-Subjects Experimental Study (Preprint)

Author:

Schmollinger MartinORCID,Gerstner JessicaORCID,Stricker EricORCID,Muench AlexanderORCID,Breckwoldt BenjaminORCID,Sigle ManuelORCID,Rosenberger PeterORCID,Wunderlich RobertORCID

Abstract

BACKGROUND

Digitalization of disaster medicine has great potential to accelerate rescue operations and, therefore, to save lives. The handling of disasters with mass casualties requires a detailed picture of the situation. Currently, first responders manually write triage results of patients on cards. Short information is communicated to the command post using radiocommunication. While this procedure is established in practice, it also implies several time-consuming and error-prone tasks. We address these issues by design, implementation and evaluation of an App-based mobile system. Within the system, the user can document responder details, triage categories, injury pattern, GPS location among other important information and transfer it automatically to the incident commanders.

OBJECTIVE

The aim of the study was to design and evaluate an App-based mobile system as a triage and coordination tool for emergency and disaster medicine compared to the widely used paper-based system.

METHODS

Data of N=38 emergency medicine personal was assessed while they completed two triage sessions of 30 patient cards each: one session using the App-based mobile system and the other one using the paper-based tool. Accuracy of the triages and the time duration for each session were measured. Furthermore, we implemented the User Experience Questionnaire and further items to assess the participant’s subjective ratings of the two triage tools.

RESULTS

Our 2 (triage tool) x 2 (tool order) mixed MANOVA yielded a significant main effect for triage tool (P<.001), while post-hoc analyses indicated that participants were significantly faster (P<.001) and assigned more patients to the correct triage category (P=.005) using the App-based mobile system compared to the paper-based tool. In addition, analyses yielded significantly better subjective ratings for the App-based mobile system than for the paper-based tool in terms of school grading (P<.001) and the six scales of the User Experience Questionnaire (all P<.001). Overall, 94.7% (36/38) stated to prefer the App-based mobile system. There was no significant main effect for tool order (P=.243) in our model.

CONCLUSIONS

We were able to show that, that an App-based mobile system cannot only keep up with the conventional paper-based tool, but even surpass it in terms of efficiency and usability. This could further expand the potential of digitalization to optimize processes in disaster medicine, which could in turn save more lives.

Publisher

JMIR Publications Inc.

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