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How will disaster victims react to first responder commands—A survey of simulated disaster victims

Sophie Monnier-Serov, MD, MPH, Abhinav Gupta, MD, Virginia Mangolds, PhD, FNP-C, ENP-C, John P. Broach, MD, MPH, MBA, FACEP, Laurel O’Connor, MD, Andrew Milsten MD, MS FACEP

Abstract


Objective: To determine whether victim behavior and interaction with triage personnel would conform to expected actions as dictated by the Simple Triage and Rapid Treatment (START) triage methodology, which emphasizes that victims will accept their assigned triage category.

Methods: In total, 105 volunteers were recruited to complete a 32-question survey after portraying victims in a triage-focused mass casualty incident (MCI) simulation. Questions included sociodemographic characteristics, willingness to follow commands of first responders, and willingness to help first responders. The authors examined whether the outcomes differed by demographics, healthcare experience, or disaster exposure of participants.

Results: The survey response rate was 90 percent (95/105). The mean age of participants was 31 years (58 percent women). Half of respondents indicated that they would ask responders to change their triage color if they disagreed with it and 75 percent would ask first responders to change their friend or family members’ triage colors. Twenty-one percent of victims reported that they would alter their own triage tag to receive treatment faster and 38 percent would alter a friend or family member’s triage color. The youngest (<20 years) and oldest (>40 years) respondents were most likely to act maladaptively.

Conclusion: Triage algorithms rely upon victims following the instructions of rescuers. This study suggests that maladaptive behavior by some victims should be anticipated.


Keywords


mass casualty incident, victim behavior, triage, emergency preparedness, first responder

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References


Turner CD, Lockey DJ, Rehn M: Prehospital management of mass casualty civilian shootings: A systematic literature review. Crit Care. 2016; 20(1): 362.

Frykberg ER: Medical management of disasters and mass casualties from terrorist bombings: How can we cope? J Trauma Acute Care Surg. 2002; 53(2): 201-212.

Kahn CA, Schultz CH, Miller KT, et al.: Does START triage work? An outcomes assessment after a disaster. Ann Emerg Med. 2009; 54(3): 424-430.

Jenkins JL, McCarthy ML, Sauer LM, et al.: Mass-casualty triage: Time for an evidence-based approach. Prehosp Disaster Med. 2008; 23(1): 3-8.

Sasser S: Field triage in disasters. Prehosp Emerg Care. 2006; 10(3): 322-323.

Hart A, Nammour E, Mangolds V, et al.: Intuitive versus algorithmic triage. Prehosp Disaster Med. 2018; 33(4): 355-361.

Jacobs L: The Hartford consensus: How to maximize survivability in active shooter and intentional mass casualty events. World J Surg. 2014; 38(5): 1007-1008.

Jacobs LM, Warshaw AL, Burns KJ: Empowering the public to improve survival in mass casualty events. Ann Surg. 2016; 263(5): 860-861.

Gates JD, Arabian S, Biddinger P, et al.: The initial response to the Boston marathon bombing: lessons learned to prepare for the next disaster. Ann Surg. 2014; 260(6): 960.

Auf der Heide E: Common misconceptions about disasters: Panic, the “Disaster Syndrome,” and Looting. In O’Leary M, ed., The First 72 Hours: A Community Approach to Disaster Preparedness. Lincoln, Nebraska: iUniverse Publishing; 2004: 340-380.




DOI: https://doi.org/10.5055/ajdm.2020.0376

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