TY - JOUR
T1 - Population-based Triage Management in Response to Surge-capacity Requirements during a Large-scale Bioevent Disaster
AU - Burkle, Frederick M.
N1 - Funding Information:
Supported in part by National Health and Medical Research Council grant 409973: Avian Influenza—National Perception of Risks to Paramedics and Service Population-based Models of Surveillance and Triage, University of Queensland and Monash University, Australia.
PY - 2006/11
Y1 - 2006/11
N2 - Both the naturally occurring and deliberate release of a biological agent in a population can bring catastrophic consequences. Although these bioevents have similarities with other disasters, there also are major differences, especially in the approach to triage management of surge capacity resources. Conventional mass-casualty events use uniform methods for triage on the basis of severity of presentation and do not consider exposure, duration, or infectiousness, thereby impeding control of transmission and delaying recognition of victims requiring immediate care. Bioevent triage management must be population based, with the goal of preventing secondary transmission, beginning at the point of contact, to control the epidemic outbreak. Whatever triage system is used, it must first recognize the requirements of those Susceptible but not exposed, those Exposed but not yet infectious, those Infectious, those Removed by death or recovery, and those protected by Vaccination or prophylactic medication (SEIRV methodology). Everyone in the population falls into one of these five categories. This article addresses a population approach to SEIRV-based triage in which decision making falls under a two-phase system with specific measures of effectiveness to increase likelihood of medical success, epidemic control, and conservation of scarce resources.
AB - Both the naturally occurring and deliberate release of a biological agent in a population can bring catastrophic consequences. Although these bioevents have similarities with other disasters, there also are major differences, especially in the approach to triage management of surge capacity resources. Conventional mass-casualty events use uniform methods for triage on the basis of severity of presentation and do not consider exposure, duration, or infectiousness, thereby impeding control of transmission and delaying recognition of victims requiring immediate care. Bioevent triage management must be population based, with the goal of preventing secondary transmission, beginning at the point of contact, to control the epidemic outbreak. Whatever triage system is used, it must first recognize the requirements of those Susceptible but not exposed, those Exposed but not yet infectious, those Infectious, those Removed by death or recovery, and those protected by Vaccination or prophylactic medication (SEIRV methodology). Everyone in the population falls into one of these five categories. This article addresses a population approach to SEIRV-based triage in which decision making falls under a two-phase system with specific measures of effectiveness to increase likelihood of medical success, epidemic control, and conservation of scarce resources.
KW - bioevents
KW - disaster
KW - epidemics
KW - pandemics
KW - population-based medicine
KW - surge capacity
KW - triage
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U2 - 10.1197/j.aem.2006.06.040
DO - 10.1197/j.aem.2006.06.040
M3 - Article
C2 - 17015415
AN - SCOPUS:33751016380
SN - 1069-6563
VL - 13
SP - 1118
EP - 1129
JO - Academic Emergency Medicine
JF - Academic Emergency Medicine
IS - 11
ER -