Translational Triage Tool IV

Mass casualty incidents (MCI) differ from multiple casualty incidents by the number of casualties versus available resources, requiring the MCI triage to differentiate between noncritically and critically injured casualties. MCI's unpredictable nature calls for an "all-hazards" approach. Triage begins at the incident scene, with primary triage determining treatment and transport priorities, followed by secondary triage at the casualty clearing station and before hospital transport.The lack of consensus on the optimal prehospital triage system poses threats to MCIs, disasters, and in a broader perspective public health emergency (DPHE), especially during multiagency collaboration. Prehospital triage during disasters and public health emergencies (DPHEs) differs from hospital emergency department (ED) triage due to resource availability. Although speed, precision, fairness, and compatibility are crucial in both settings, prehospital triage prioritizes speed over precision, while hospital triage can maximize precision.<b>Study Type:</b> We aim to conduct a clinical case series study. A comparative study, analyzing quantitative data from several institutional triage systems and comparing these with TTT among patients from real events. We will also conclude whether TTT is feasible to use in practice. This approach is often used in quantitative research to explore relationships, differences, or trends among variables, providing a systematic and objective analysis to generate reliable and generalizable findings. It is crucial in research as it enables researchers to make informed decisions, identify patterns, and test hypotheses, ensuring that the results are accurate, valid, and applicable to broader populations<b>Objectives:</b> To compare institutional triage systems and TTT among patients from real events to conclude whether TTT is feasible to use in practice.<b>Study Design:</b> In this study, patients managed by an ambulance crew will be handled according to the local routines and triage system. The institutional triage outcome will be registered and compared with the outcome of TTT, utilized by research assistants (observers) who follow the ambulance to the incident.No patient characteristics except the primary cause of alarm, gender, and age will be registered.<b>Participants:</b> Observers are recruited from the following countries: Iran, Poland, Saudi Arabia, Spain, and Thailand to independently perform primary triage on emergency patients who are assessed by ambulance crew at the prehospital field before admission to the hospital. The observers will be trained healthcare staff with long experience in emergency care. They will be trained in scientific observation, performing the TTT algorithm, and obtaining ethical knowledge and understanding. The observations will be direct, meaning that when healthcare professionals examine the patient, and non-participatory, i.e., the observer will not interfere with the work of the healthcare staff. Patient consent will be collected after the emergency is resolved. The data for those unwilling to participate will be deleted.<b>Power calculation: </b>This study aims<b> </b>to perform a clinical case series study. Consequently, no power calculation is needed as its goal is to create a hypothesis. However, if the outcome indicates a relationship, this study can be followed up with a larger study, using a registry, randomized clinical trial, or retrospective study when power calculation can be used.<b>Data Collection Methods:</b> Patients are numbered, and the triage outcome will be registered and directly compared with the routine triage outcome. See registration protocol. The period of data collection will be from September 2024 to March 2025.<b>Analysis Plan:</b> Quantitively, using simple or expanded statistics, if needed. The analysis period will be from April to May 2025.<b>Ethical Considerations:</b> No patient characteristics are registered. Patient consent will be asked post-event. The study will adhere to the ethical requirements established in each country.<b>Timeline:</b> September 2024 to August 2025.<b>Budget:</b> No central budget. The study will be financed locally and by participating researchers.