Summary of Triage after Wenchuan Earthquake in 2 Weeks_Chinese Journal of Evidence-Based Medicine

Authors：

JIANG Yaowen ¹ , ZHANG Jiancheng ¹ , ZHONG Yan ² , LI Dajiang ² , ZHANG Weidong ² , ZENG Zhi ³ , WANG Yiping ¹ ,  CAO Yu ¹

1. Emergency Department, West China Hospital, Sichuan University, Chengdu 610041, China2. Department of Medical Affairs, West China Hospital, Sichuan University, Chengdu 610041, China3. Department of Internal Medical, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

CAO Yu, Email: dr.yu.cao@gmail.com

Keywords：

Wenchuan earthquake; Medical rescue; Triage

DOI：

10.7507/1672-2531.20080163

Video：

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Objective 　To discuss the mode of triage patient in Emergency Department of West China Hospital of Sichuan University after the Wenchuan earthquake and the major experience during the process.
Method 　The patients’ severity level of injury and waiting time for medical care in Emergency Department were analyzed after earthquake in 2 weeks.
Result 　375 patients were triaged into the severity level and get the treatment followed the triage systems gave the highest rate of survival and lowest rate of over triage and under triage.
Conclusion 　In the calamity of Wenchuan earthquake with large number of casualties, Emergency Department automatically shifted into disaster mode and triage victims by the irregular triage systems. In this situation, medical staff do not just triage the patients to the Emergency Department or to see a doctor, but triage the victims to the medical care immediately and efficiently. By the new triage system, the West China Hospital saves more lives in less time.

Citation： JIANG Yaowen,ZHANG Jiancheng,ZHONG Yan,LI Dajiang,ZHANG Weidong,ZENG Zhi,WANG Yiping,CAO Yu. Summary of Triage after Wenchuan Earthquake in 2 Weeks. Chinese Journal of Evidence-Based Medicine, 2008, 08(9): 722-725. doi: 10.7507/1672-2531.20080163 Copy

1.	Milzman DP, Boulanger BR, Rodriguez A, et al. Pre-existing disease in trauma patients: A predictor of fate independent of age and ISS. J Trauma, 1992, 32(2): 236-243.
2.	Champion HR, Sacco WJ, Hannan DS, et al. Assessment of injury severity: The triage index. Crit Care Med, 1980, 8(4): 201-208.
3.	Winkler JV, Rosen P, Alfry EJ. Prehospital use of the Glasgow Coma Scale in severe head injury. J Emerg Med, 1984, 2(1): 1-6.
4.	Meredith W, Rutledge R, Hansen AR, et al. Field triage of patients based upon the availability to follow commands: A study in 29,573 patients. J Trauma, 1995, 38(1):　129-135.
5.	Kirkpatrick JR, Youmans RL. Trauma index: An aide in evaluation of injury victims. J Trauma, 1971, 11(8): 711-714.
6.	Yoshimura N, Nakayama S, Nakagiri K, et al. Profile of chest injuries arising from the 1995 Southern Hyogo Prefecture earthquake. Chest, 1996, 110(3): 759-761.
7.	Bywaters EGL, Beal D. Crush injuries and renal function. Br Med J, 1941, 1: 427-434.
8.	Coll ins AJ, Burzstein S. Renal failure in disasters. Crit Care Clin, 1991, 7(2): 421-435.
9.	Osler T, Hales K, Baack B, et al. Trauma in the elderly. Am J Surg, 1988, 156(6): 537-543.
10.	Morris JA, MacKenzie EJ, Edelstein S. The effect of pre-existing conditions on mortality in trauma patients. JAMA, 1990, 263(14): 1942-1945.
11.	Sacco WJ, Copes WS, Bain Jr LW, et al. Effect of preinjury illness on trauma patient survival outcome. J Trauma, 1993, 35(4): 538-542.
12.	Emerman CL, Shade B, Kubincanek J. A comparison of EMT judgment and prehospital trauma triage instruments. J Trauma, 1991, 31(10): 1369-1375.
13.	Ornato J, Milnek EJ, Craren EF, et al. Ineffectiveness of the Trauma Score and the CRAMS Scale for accurately triaging patients to trauma centers. Ann Emerg Med, 1985, 14(11): 1061-1064.
14.	Benson M, Koenig KL, Schultz CH. Disaster triage: START, then SAVE: a new method of dynamic triage for victims of a catastrophic earthquake. Prehosp Disaster Med (in press).

1. Milzman DP, Boulanger BR, Rodriguez A, et al. Pre-existing disease in trauma patients: A predictor of fate independent of age and ISS. J Trauma, 1992, 32(2): 236-243.
2. Champion HR, Sacco WJ, Hannan DS, et al. Assessment of injury severity: The triage index. Crit Care Med, 1980, 8(4): 201-208.
3. Winkler JV, Rosen P, Alfry EJ. Prehospital use of the Glasgow Coma Scale in severe head injury. J Emerg Med, 1984, 2(1): 1-6.
4. Meredith W, Rutledge R, Hansen AR, et al. Field triage of patients based upon the availability to follow commands: A study in 29,573 patients. J Trauma, 1995, 38(1):　129-135.
5. Kirkpatrick JR, Youmans RL. Trauma index: An aide in evaluation of injury victims. J Trauma, 1971, 11(8): 711-714.
6. Yoshimura N, Nakayama S, Nakagiri K, et al. Profile of chest injuries arising from the 1995 Southern Hyogo Prefecture earthquake. Chest, 1996, 110(3): 759-761.
7. Bywaters EGL, Beal D. Crush injuries and renal function. Br Med J, 1941, 1: 427-434.
8. Coll ins AJ, Burzstein S. Renal failure in disasters. Crit Care Clin, 1991, 7(2): 421-435.
9. Osler T, Hales K, Baack B, et al. Trauma in the elderly. Am J Surg, 1988, 156(6): 537-543.
10. Morris JA, MacKenzie EJ, Edelstein S. The effect of pre-existing conditions on mortality in trauma patients. JAMA, 1990, 263(14): 1942-1945.
11. Sacco WJ, Copes WS, Bain Jr LW, et al. Effect of preinjury illness on trauma patient survival outcome. J Trauma, 1993, 35(4): 538-542.
12. Emerman CL, Shade B, Kubincanek J. A comparison of EMT judgment and prehospital trauma triage instruments. J Trauma, 1991, 31(10): 1369-1375.
13. Ornato J, Milnek EJ, Craren EF, et al. Ineffectiveness of the Trauma Score and the CRAMS Scale for accurately triaging patients to trauma centers. Ann Emerg Med, 1985, 14(11): 1061-1064.
14. Benson M, Koenig KL, Schultz CH. Disaster triage: START, then SAVE: a new method of dynamic triage for victims of a catastrophic earthquake. Prehosp Disaster Med (in press).

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