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First Responder Accuracy Using SALT after Brief Initial Training

Published online by Cambridge University Press:  01 September 2015

Christopher W.C. Lee ,
Shelley L. McLeod  and
Michael B. Peddle
Christopher W.C. Lee*
Affiliation:
Division of Emergency Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
Shelley L. McLeod
Affiliation:
Division of Emergency Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
Michael B. Peddle
Affiliation:
Division of Emergency Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada Southwestern Ontario Regional Base Hospital Program, Central Region, London, Ontario, Canada
*
Correspondence: Christopher Lee, MD, BASc Schulich School of Medicine and Dentistry Division of Emergency Medicine Department of Medicine Western University London, Ontario, Canada, N6A 5W9 E-mail: clee2011@meds.uwo.ca
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Abstract

Background

Mass-casualty incidents (MCIs) present a unique challenge with regards to triage as patient volume often outweighs the number of available Emergency Medical Services (EMS) providers. A possible strategy to optimize existing triage systems includes the use of other first responder groups, namely fire and police, to decrease the triage time during MCIs, allowing for more rapid initiation of life-saving treatment and prioritization of patient transport.

Hypothesis

First-year primary care paramedic (PCP), fire, and police trainees can apply with similar accuracy an internationally recognized MCI triage tool, Sort, Assess, Life-saving interventions, Treatment/transport (SALT), immediately following a brief training session, and again three months later.

Methods

All students enrolled in the PCP, fire, and police foundation programs at two community colleges were invited to participate in a 30-minute didactic session on SALT. Immediately following this session, a 17-item, paper-based test was administered to assess the students’ ability to understand and apply SALT. Three months later, the same test was given to assess knowledge retention.

Results

Of the 464 trainees who completed the initial test, 364 (78.4%) completed the three month follow-up test. Initial test scores were higher (P<.05) for PCPs (87.0%) compared to fire (80.2%) and police (68.0%) trainees. The mean test score for all respondents was higher following the initial didactic session compared to the three month follow-up test (75% vs 64.7%; Δ 10.3%; 95% CI, 8.0%-12.6%). Three month test scores for PCPs (75.4%) were similar to fire (71.4%) students (Δ 4.0%; 95% CI, −2.1% to 10.1%). Both PCP and fire trainees significantly outperformed police (57.8%) trainees. Over-triage errors were the most common, followed by under-triage and then critical errors, for both the initial and follow-up tests.

Conclusions

Amongst first responder trainees, PCPs were able to apply the SALT triage tool with the most accuracy, followed by fire, then police. Over-triage was the most frequent error, while critical errors were rare.

LeeCWC, McLeodSL, PeddleMB. First Responder Accuracy Using SALT after Brief Initial Training. Prehosp Disaster Med. 2015;30(5):447–451.

Keywords

Emergency Medical Servicesfire and rescue personnelmass-casualty incidentspolicetriage
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 30 , Supplement 5 , October 2015 , pp. 447 - 451
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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