Comparison of Medical Students and Paramedics Using Simple Triage and Rapid Treatment and Sacco Triage Method in Mass Casualty Incident: A Simulated Cohort Study

In a mass casualty incident (MCI), when medical resources are overwhelmed by the number and severity of casualties, victims’ triage plays a crucial role in disaster management. This study aimed to assess the difference between two triage methods, Simple Triage and Rapid Treatment (START) and Sacco Triage Method (STM), in an MCI scenario and determine which way leads to more accurate and quick triage results.

 In this simulated prospective cohort study, observers were selected among 2nd-year medical students and newly graduated paramedics and presented with an imaginary disaster scenario. Half of the medical students and paramedics used the START method, and the other half prioritized patients with STM. The triage results accuracy, time to triage, and time to evacuation in the two methods were recorded and analyzed.

One-hundred-fifty observers were divided into four groups. All of them were male, and their mean age was 20.37±1.22 years. The overall accuracy for STM was 89.52% which showed a better and statistically significant performance than the START method (p<0.001). The mean time to triage for each patient in START and STM was 14.29+-2.95 and 16.84+-3.33 seconds, respectively. The mean time to evacuation for each triage method was 4.76+-.98 minutes for START and 5.61+-1.11 minutes for STM. In both STM and START groups, medical students performed better in triage than paramedics (p<0.001 for START and p=0.025 for STM). Medical students were also significantly faster than paramedics in the time to triage and evacuation categories in the STM group (p<0.001).

In conclusion, 2nd-year medical students and newly graduated paramedics performed a more accurate and quicker triage with STM than the START method.