Israel Defense Forces Medical Corps, Field Hospital, Jerusalem, Israel.
Prehosp Disaster Med. 2011 Oct;26(5):386-90. doi: 10.1017/S1049023X11006856. Epub 2012 Jan 27.
Mass-casualty triage is implemented when available resources are insufficient to meet the needs of all patients in a disaster situation. The basic principle is to do the maximum good for the most casualties with the least amount of resources. There are limited data to support the applicability of this principle in massive disasters such as the January 2010 earthquake in Haiti, in which the number of patients seeking medical attention overwhelmed the local resources.
To analyze the application of a triage system developed for use in a mass-casualty setting with limited resources. The system was designed to admit only those patients who had medical conditions requiring urgent treatment that were within the capabilities of the hospital and had a good chance of survival after discharge. Priority was given to those whose treatment could be administered within a short hospital stay.
A retrospective, observational review of computerized registration forms of Haitian earthquake victims who sought medical care at a 72-bed field hospital within four to 14 days after the event. An analysis of the efficacy of the triage protocol that was used followed, using length of hospital stay to measure consumption of resources.
A total of 1,111 patients were triaged for treatment in the field hospital within 14 days of the earthquake. The median length of stay for all patients for whom data was available was 16 hours (mean = 29.7 hours). The majority of patients (n = 620, 65%) were discharged within 24 hours. Two hundred five patients underwent surgery and were discharged within a median of 39 hours (mean = 52.6 hours); of these, 124 (62%) were discharged within 48 hours. The total mortality of the treated patients was 1.5% (n = 17).
Currently accepted triage principles for the most part are appropriate for efficiently providing medical care in a disaster area with extremely limited resources, but require extensive adaptation to local conditions.
当可用资源不足以满足灾难情况下所有患者的需求时，就会实施大规模伤亡分诊。其基本原则是用最少的资源为最多的伤员带来最大的好处。在海地 2010 年 1 月地震等大规模灾害中，寻求医疗的患者人数超过了当地资源，这方面仅有有限的数据支持该原则的适用性。
分析在资源有限的大规模伤亡情况下应用分诊系统的情况。该系统旨在仅收治那些医疗状况需要紧急治疗且医院有能力治疗、出院后有良好生存机会的患者。优先考虑那些可以在短时间住院治疗的患者。
对事件发生后 4 至 14 天内在一家 72 张床位的野战医院接受治疗的海地地震灾民的计算机登记表格进行回顾性、观察性审查。随后分析所使用的分诊方案的效果，以住院时间长短来衡量资源消耗。
在地震发生后 14 天内，共有 1111 名患者在野战医院接受了分诊治疗。所有可获得数据患者的中位住院时间为 16 小时（平均值=29.7 小时）。大多数患者（n=620，65%）在 24 小时内出院。205 名患者接受了手术，中位出院时间为 39 小时（平均值=52.6 小时）；其中 124 名（62%）在 48 小时内出院。接受治疗的患者总死亡率为 1.5%（n=17）。
目前，在资源极其有限的灾区，接受的分诊原则在很大程度上是合理的，可以有效地提供医疗服务，但需要根据当地情况进行广泛调整。
