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一种新的烧伤灾难分诊方法:快速烧伤分诊(FTB)。

A New Triage Method for Burn Disasters: Fast Triage in Burns (FTB).

机构信息

Department of Burns, Plastic and Reconstructive Surgery, Military Institute of Medicine, Warsaw, Poland.

Centre for the Treatment of Burns, Siemianowice Śląskie, Poland.

出版信息

Med Sci Monit. 2018 Mar 31;24:1894-1901. doi: 10.12659/msm.905197.

Abstract

BACKGROUND There are few triage methods based on patient age and extent of burn. However, in case of mass casualties, age might be hard to define. Burn segregation in mass-casualty accidents requires an easy, fast, and effective method. Triage in burns should also segregate casualties requiring treatment in burn centers. The aim of this study was to create a proprietary segregation algorithm dedicated to mass-casualty incidents. MATERIAL AND METHODS A retrospective analysis of 939 burned patients admitted to the Clinical Department of Burns, Plastic and Reconstructive Surgery, Military Institute of Medicine (MIM) in Warsaw and to the Center for the Treatment of Burns (CTB) in Siemianowice Śląskie in 2012 and 2013 was performed. The aim was to reveal which early factors could be used during segregation of burn victims in mass-casualty incidents on the battlefield and in civilian circumstances. Only easy and quick-to-evaluate factors that can be examined without medical equipment and laboratory tests were used in creating the proprietary triage algorithm. RESULTS As a result of our study, we created an algorithm for fast triage in mass-casualty situations. The algorithm is based on parameters that can be easily evaluated without additional equipment. To create the algorithm, we used factors that had the strongest impact on mortality prediction in severely burned patients, in multifactor analysis: advanced age (p<0.001. OR=1.04), extent of the deep burn (p<0.001. OR=1.1), and low systolic arterial pressure (p<0.001. OR=0.96). CONCLUSIONS The FTB (Fast Triage in Burns) algorithm is a new triage method dedicated for massive burn events in civilian circumstances. The FTB algorithm is a simple, quick, and credible means of segregating burn victims. The algorithm is dedicated to use in pre-hospital care, during mass-casualty events both in civilian and battlefield circumstances. The aim is to be able to evaluate burn victims immediately, without access to medical equipment or additional tests and to evaluate indications for burn center care. It is a unique method designed to be used during segregation in isolated burn mass-casualty incidents.

摘要

背景

基于患者年龄和烧伤程度的分诊方法很少。然而,在大规模伤亡情况下,年龄可能难以界定。大规模伤亡事故中的烧伤分诊需要一种简单、快速和有效的方法。烧伤分诊还应将需要在烧伤中心治疗的伤员分开。本研究的目的是创建一种专用于大规模伤亡事故的专用分诊算法。

材料和方法

对 2012 年和 2013 年在华沙军事医学研究所(MIM)烧伤科和西里西亚斯米亚诺维采烧伤治疗中心收治的 939 名烧伤患者进行回顾性分析。目的是揭示在战场上和民用环境中大规模伤亡事件中,哪些早期因素可用于烧伤患者的分诊。在创建专有的分诊算法时,仅使用易于评估且无需医疗设备和实验室检查即可检查的快速评估因素。

结果

通过我们的研究,我们创建了一种用于大规模伤亡情况下快速分诊的算法。该算法基于无需额外设备即可轻松评估的参数。为了创建算法,我们使用了多因素分析中对严重烧伤患者死亡率预测影响最大的因素:年龄较大(p<0.001,OR=1.04)、深度烧伤面积较大(p<0.001,OR=1.1)和收缩压较低(p<0.001,OR=0.96)。

结论

FTB(烧伤快速分诊)算法是一种专用于民用环境中大规模烧伤事件的新分诊方法。FTB 算法是一种简单、快速、可靠的方法,可以将烧伤患者分开。该算法专门用于院外急救,在民用和战场环境中的大规模伤亡事件中使用。目的是能够在没有医疗设备或额外检查的情况下立即评估烧伤患者,并评估烧伤中心护理的指征。这是一种独特的方法,旨在用于孤立的烧伤大规模伤亡事件中的分诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a44/5892463/e669f3385411/medscimonit-24-1894-g001.jpg

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