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Author (up) Zoraster, R.M.; Chidester, C.; Koenig, W. openurl 
  Title Field triage and patient maldistribution in a mass-casualty incident Type Journal Article
  Year 2007 Publication Prehosp Disaster Med Abbreviated Journal  
  Volume 22 Issue 3 Pages 224-229  
  Keywords major incident report  
  Abstract INTRODUCTION: Management of mass-casualty incidents should optimize outcomes by appropriate prehospital care, and patient triage to the most capably facilities. The number of patients, the nature of injuries, transportation needs, distances, and hospital capabilities and availabilities are all factors to be considered. Patient maldistributions such as overwhelming individual facilities, or transport to facilities incapable of providing appropriate care should be avoided. This report is a critical view of the application of the START triage nomenclature in the prehospital arena following a train crash in Los Angeles County on 26 January 2005. METHODS: A scheduled debriefing was held with the major fire and emergency medical services responders, Medical Alert Center staff, and hospitals to assess and review the response to the incident. Site visits were made to all of the hospitals involved. Follow-up questions were directed to emergency department staff that were on duty during the day of the incident. RESULTS: The five Level-I Trauma Centers responded to the poll with the capacity to receive a total of 12 “Immediate” patients, 2.4 patients per center, the eight Level-II Trauma Centers responded with capacity to receive 17 “Immediate” patients, two patients per center, while the 25 closest community hospitals offered to accept 75 “Immediate” patients, three patients per hospital. These community hospitals were typically about one-half of the size of the trauma centers (average 287 beds versus 548, average 8.7 operating rooms versus 16.6). Twenty-six patients were transported to a community hospital >15 miles from the scene, while eight closer community hospitals did not receive any patients. CONCLUSIONS: The debriefing summary of this incident concluded that there were no consistently used criteria to decide ultimate destination for “Immediates”, and that they were distributed about equally between community hospitals and trauma centers.  
  Corporate Author Thesis  
  Publisher Place of Publication Los Angeles County Emergency Medical Services, Commerce, California 90022-5152, USA. rzoraster@ladhs Editor  
  Language Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1049-023X (Print) ISBN Medium  
  Area Expedition Conference  
  Notes Approved no  
  Call Number refbase @ admin @ Zoraster2007 Serial 6846  
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