Sorbonne Université.
Department of Anaesthesiology and Critical Care Paris, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP).
Eur J Emerg Med. 2021 Apr 1;28(2):136-143. doi: 10.1097/MEJ.0000000000000771.
Triage is key in the management of mass casualty incidents.
The objective of this study was to assess the prehospital triage performed during the 2015 Paris area terrorist attack.
This was a retrospective cohort study that included all casualties of the attacks on 13 November 2015 in Paris area, France, that were admitted alive at the hospital within the first 24 h after the events. Patients were triaged as absolute emergency or relative emergency by a prehospital physician or nurse. This triage was then compared to the one of an expert panel that had retrospectively access to all prehospital and hospital files.
The primary endpoints were the rate of overtriage and undertriage, defined as number of patients misclassified in one triage category, divided by the total number of patients in this triage category.
Among 337 casualties admitted to the hospital, 262 (78%) were triaged during prehospital care, with, respectively, 74 (28%) and 188 (72%) as absolute and relative emergencies. Among these casualties, the expert panel classified 96 (37%) patients as absolute emergencies and 166 (63%) as relative emergency. The rate of undertriage and overtriage was 36% [95% confidence interval (CI), 27-47%] and 8% (95% CI, 4-13%), respectively. Among undertriaged casualties, 8 (23%) were considered as being severely undertriaged. Among overtriaged casualties, 10 (77%) were considered as being severely overtriaged.
A simple prehospital triage for trauma casualties during the 13 November terrorist attack in Paris could have been performed triaged in 78% of casualties that were admitted to the hospital, with a 36% rate of undertriage and 8% of overtriage. Qualitative analysis of undertriage and overtriage indicate some possibilities for further improvement.
分诊在突发事件中的伤员管理中起着关键作用。
本研究旨在评估 2015 年巴黎地区恐怖袭击事件中的院前分诊情况。
设计、地点和参与者：这是一项回顾性队列研究，纳入了 2015 年 11 月 13 日法国巴黎地区袭击事件中所有在事件发生后 24 小时内被送往医院的存活伤员。院前医生或护士将伤员分诊为绝对紧急或相对紧急。然后，这种分诊与一个专家小组的分诊进行了比较，该专家小组可以回顾性地获得所有院前和医院的病历。
主要终点是过诊和漏诊的发生率，定义为分类错误的患者数除以该分类的总患者数。
在被送往医院的 337 名伤员中，262 名（78%）在院前护理期间接受了分诊，其中分别有 74 名（28%）和 188 名（72%）被分类为绝对紧急和相对紧急。在这些伤员中，专家组将 96 名（37%）患者分类为绝对紧急，166 名（63%）为相对紧急。过诊和漏诊的发生率分别为 36%（95%置信区间，27%-47%）和 8%（95%置信区间，4%-13%）。在漏诊的伤员中，有 8 名（23%）被认为严重漏诊。在过诊的伤员中，有 10 名（77%）被认为严重过诊。
在 11 月 13 日巴黎恐怖袭击中，对创伤伤员进行了一种简单的院前分诊，可对 78%的住院伤员进行分诊，过诊率为 36%，漏诊率为 8%。对过诊和漏诊的定性分析表明，有进一步改进的可能。
Zotero 插件