1.Academic and Community Emergency Specialists,Uniontown,OhioUSA.
3.Research Group on Emergency and Disaster Medicine (ReGEDiM),Vrije Universiteit Brussel,Brussels,Belgium.
Prehosp Disaster Med. 2019 Aug;34(4):401-406. doi: 10.1017/S1049023X1900462X.
The aim of this study was to determine if school personnel can understand and apply the Sort, Assess, Life-saving interventions, Treat/Transport (SALT) triage methods after a brief training. The investigators predicted that subjects can learn to triage with accuracy similar to that of medically trained personnel, and that subjects can pass an objective-structured clinical exam (OSCE) evaluating hemorrhage control.
School personnel were eligible to participate in this prospective observational study. Investigators recorded subject demographic information and prior medical experience. Participants received a 30-minute lecture on SALT triage and a brief lecture and demonstration of hemorrhage control and tourniquet application. A test with brief descriptions of mass-casualty victims was administered immediately after training. Participants independently categorized the victims as dead, expectant, immediate, delayed, or minimal. They also completed an OSCE to evaluate hemorrhage control and tourniquet application using a mannequin arm.
Subjects from two schools completed the study. Fifty-nine were from a private school that enrolls early childhood through grade eight, and 45 from a public school that enrolls grades seven and eight (n = 104). The average subject age was 45 years and 68% were female. Approximately 81% were teachers and 87% had prior cardiopulmonary resuscitation (CPR) training. Overall triage accuracy was 79.2% (SD = 10.7%). Ninety-six (92.3%) of the subjects passed the hemorrhage control OSCE.
After two brief lectures and a short demonstration, school personnel were able to triage descriptions of mass-casualty victims with an overall accuracy similar to medically trained personnel, and most were able to apply a tourniquet correctly. Opportunities for future study include integrating high-fidelity simulation and mock disasters, evaluating for knowledge retention, and exploring the study population's baseline knowledge of medical care, among others.
本研究旨在确定经过简短培训后，学校人员是否能够理解和应用 Sort、Assess、Life-saving interventions、Treat/Transport（SALT）分诊方法。研究人员预测，受试者可以学习准确分诊，准确率与受过医学培训的人员相似，并且受试者可以通过评估出血控制的客观结构化临床考试（OSCE）。
学校人员有资格参加这项前瞻性观察研究。研究人员记录了受试者的人口统计学信息和先前的医疗经验。参与者接受了 30 分钟的 SALT 分诊讲座，以及简短的讲座和出血控制和止血带应用演示。培训后立即进行了一项包含大量伤员简要描述的测试。参与者独立将受害者分类为死亡、期待、立即、延迟或轻微。他们还使用人体模型手臂完成了一项 OSCE，以评估出血控制和止血带应用。
两所学校的 104 名受试者完成了研究。59 名来自一所从幼儿园到八年级的私立学校，45 名来自一所从七年级到八年级的公立学校（n=104）。受试者的平均年龄为 45 岁，68%为女性。大约 81%是教师，87%接受过心肺复苏（CPR）培训。总体分诊准确率为 79.2%（SD=10.7%）。96（92.3%）名受试者通过了出血控制 OSCE。
经过两次简短的讲座和一次简短的演示，学校人员能够对大量伤员的描述进行分诊，准确率与受过医学培训的人员相似，并且大多数人能够正确使用止血带。未来的研究机会包括整合高保真模拟和模拟灾难、评估知识保留情况以及探索研究人群对医疗保健的基线知识等。
