Background: The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt\nintervention and/or evacuation. The objective of the present study was to evaluate triage decision skills in a Mass\nCasualty Incident drill. The study compares two groups of participants in Advanced Trauma Life Support and Pre-\nHospital Trauma Life Support courses.\nMethods: A questionnaire was used to deal with three components of triage of victims in a Mass Casualty Incident:\ndecision-making; prioritization of 15 hypothetical casualties involved in a bus crash; and prioritization for evacuation.\nSwedish Advanced Trauma Life Support and Pre-Hospital Trauma Life Support course participants filled in the same\ntriage skills questionnaire just before and after their respective course.\nResults: One hundred fifty-three advanced Trauma Life Support course participants were compared to 175 Pre-\nHospital Trauma Life Support course participants. The response rates were 90% and 95%, respectively. A significant\nimprovement was found between pre-test and post-test for the Pre-Hospital Trauma Life Support group in regards\nto decision-making. This difference was only noticeable among the participants who had previously participated in\nMass Casualty Incident drills or had experience of a real event (pre-test mean �± standard deviation 2.4 �± 0.68, posttest\nmean �± standard deviation 2.60 �± 0.59, P = 0.04). No improvement was found between pre-test and post-test for\neither group regarding prioritization of the bus crash casualties or the correct identification of the most injured\npatients for immediate evacuation.\nConclusions: Neither Advanced Trauma Life Support nor Pre-Hospital Trauma Life Support participants showed\ngeneral improvement in their tested triage skills. However, participation in Mass Casualty Incident drills or\nexperience of real events prior to the test performed here, were shown to be advantageous for Pre-Hospital\nTrauma Life Support participants. These courses should be modified in order to assure proper training in triage\nskills.
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