爆炸事件特定分诊（Bost工具）及其在医疗专业人员中的应用。
Bombings specific triage (Bost Tool) tool and its application by healthcare professionals.
作者信息
Sanjay Jaiswal, Ankur Verma, Tamorish Kole
机构信息
Department of Emergency Medicine, Paras Hospitals, Gurgaon, India.
出版信息
World J Emerg Med. 2015;6(4):289-92. doi: 10.5847/wjem.j.1920-8642.2015.04.007.
BACKGROUND
Bombing is a unique incident which produces unique patterns, multiple and occult injuries. Death often is a result of combined blast, ballistic and thermal effect injuries. Various natures of injury, self referrals and arrival by private transportation may lead to "wrong triage" in the emergency department. In India there has been an increase in incidence of bombing in the last 15 years. There is no documented triage tool from the National Disaster Management Authority of India for Bombings. We have tried to develop an ideal bombing specific triage tool which will guide the right patients to the right place at the right time and save more lives.
METHODS
There are three methods of studying the triage tool: 1) real disaster; 2) mock drill; 3) table top exercise. In this study, a table top exercise method was selected. There are two groups, each consisting of an emergency physician, a nurse and a paramedic.
RESULTS
By using the proportion test, we found that correct triaging was significantly different (P=0.005) in proportion between the two groups: group B (80%) with triage tool performed better in triaging the bomb blast victims than group A (50%) without the bombing specific triage tool performed.
CONCLUSION
Development of bombing specific triage tool can reduce under triaging.
背景
爆炸是一种独特的事件，会造成独特的损伤模式、多种隐匿性损伤。死亡往往是爆炸、弹道和热效应综合损伤的结果。不同性质的损伤、自行前来就诊以及乘坐私人交通工具前来就诊等情况，可能导致急诊科出现“错误分诊”。在印度，过去15年里爆炸事件的发生率有所上升。印度国家灾害管理局没有针对爆炸事件的分诊工具记录。我们试图开发一种理想的针对爆炸事件的分诊工具，该工具将在正确的时间将合适的患者引导至合适的地方，从而挽救更多生命。
方法
研究分诊工具的方法有三种：1）实际灾难；2）模拟演练；3）桌面演练。在本研究中，选择了桌面演练方法。有两组，每组由一名急诊医生、一名护士和一名护理人员组成。
结果
通过比例检验，我们发现两组之间正确分诊的比例存在显著差异（P = 0.005）：使用分诊工具的B组（80%）在对爆炸受害者进行分诊方面比未使用针对爆炸事件的分诊工具的A组（50%）表现更好。
结论
开发针对爆炸事件的分诊工具可以减少分诊不足的情况。
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