Citation

Hoskins JD, Graham RF, Robinson DR, Lutz CC, Folio LR. J. Am. Coll. Surg. 2009; 208(6): 1001-1008.

Affiliation

Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.

Copyright

(Copyright © 2009, American College of Surgeons, Publisher Elsevier Publishing)

DOI

10.1016/j.jamcollsurg.2009.02.044

PMID

19476883

Abstract

BACKGROUND: An intrahospital casualty throughput system modeled after air traffic control (ATC) tracking procedures was tested in mass casualty exercises. ATC uses a simple tactile process involving informational progress strips representing each aircraft, which are held in bays representing each stage of flight to prioritize and manage aircraft. These strips can be reordered within the bays to indicate a change in priority of aircraft sequence. In this study, a similar system was designed for patient tracking. STUDY DESIGN: We compared the ATC model and traditional casualty tracking methods of paper and clipboard in 18 four-hour casualty scenarios, each with 5 to 30 mock casualties. The experimental and control groups were alternated to maximize exposure and minimize training effects. Results were analyzed with Mann-Whitney statistical analysis with p value < 0.05 (two-sided). RESULTS: The ATC method had significantly (p = 0.017) fewer errors in critical patient data (eg, name, social security number, diagnosis). Specifically, the ATC method better tracked the mechanism of injury, working diagnosis, and disposition of patients. The ATC method also performed considerably better with patient accountability during mass casualty scenarios. Data strips were comparable with the control method in terms of ease of use. In addition, participants preferred the ATC method to the control (p = 0.003) and preferred using the ATC method (p = 0.003) to traditional methods in the future. CONCLUSIONS: The ATC model more effectively tracked patient data with fewer errors when compared with the clipboard method. Application of these principles can enhance trauma management and can have application in civilian and military trauma centers and emergency rooms.

Language: en