Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-19T12:39:26.729Z Has data issue: false hasContentIssue false
  • English
  • Français

Triage by Resource Allocation for INpatients: A Novel Disaster Triage Tool for Hospitalized Pediatric Patients

Published online by Cambridge University Press:  31 January 2018

Anna Lin ,
Kristine Taylor  and
Ronald S. Cohen
Anna Lin*
Affiliation:
Division of Pediatric Hospital Medicine, Stanford University, Office of Emergency Management, Lucile Packard Children's Hospital Stanford
Kristine Taylor
Affiliation:
Center for Professional Excellence & Inquiry, Nursing, Lucile Packard Children's Hospital Stanford
Ronald S. Cohen
Affiliation:
Division of Neonatology, Stanford University, Neonatology, Lucile Packard Children's Hospital Stanford
*
Correspondence and reprints request to Anna Lin, Department of Pediatrics, Division of Pediatric Hospital Medicine, 300 Pasteur Drive, MC 5776, Palo Alto, CA 94304 (e-mail: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To develop a disaster triage tool for the evacuation of hospitalized neonatal and pediatric populations.

Methods

We expanded an existing neonatal disaster triage tool for the evacuation of a children’s hospital. We assessed inpatients using bedside visual assessments and chart review to categorize patients transport level based on local emergency medical services protocols and expert opinion. The tool was refined by using multiple Plan Do Study Act cycles. Primary outcome was the number of each level of transport required for hospital evacuation. Secondary outcome was improved efficiency of obtaining information about specific transport needs for evacuation.

Results

We evaluated 1382 patients both visually and through electronic chart review over 10 random days. Accordance between visual assessment and electronic chart review reached 96.3%. During a 2 hour statewide disaster drill, no hospital units completed self-assessed transport needs for their patients; a single nurse used Triage by Resource Allocation in INpatients to determine transportation needs in less than 1 hour. (Disaster Med Public Health Preparedness. 2018;12:692-696)

Keywords

disaster planningpediatrichospital evacuationtriagesurge capacity
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 12 , Issue 6 , December 2018 , pp. 692 - 696
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. The Joint Commission. Emergency Management. 2009 Hospital Accreditation Standards. Oakbrook Terrace, IL: Joint Commission Resources; 2009.Google Scholar
2. Committee of the Future of Emergency Care in the U.S. Health System. Emergency Care for Children: Growing Pains. Washington, DC: Institute of Medicine; 2006.Google Scholar
3. Klein, KR, Pepe, PE, Burkle, FM Jr., Nagel, NE, Swienton, RE. Evolving need for alternative triage management in public health emergencies: a Hurricane Katrina case study. Disaster Med Public Health Prep. 2008;2(Suppl 1):S40-S44.Google Scholar
4. Cohen, R, Murphy, B, Ahern, T, Hackel, A. Regional disaster planning for neonatology. J Perinatol. 2010;30:709-711.Google Scholar
5. Antommaria, AH, Sweney, J, Poss, WB. Critical appraisal of: triaging pediatric critical care resources during a pandemic: ethical and medical considerations. Pediatr Crit Care Med. 2010;11:396-400.Google Scholar
6. Gausche-Hill, M. Pediatric disaster preparedness: are we really prepared? J Trauma. 2009;67(Suppl 2):S73-S76.Google Scholar
7. Diaz, A, Dinnin, K, Green, B, Kelter, A, Maniece-Harrison, B, Marans, SR, Mickalide, AD, Mollica, RF, Ricciardi, R, Rumm, PD, Wright, JA. National Advisory Committee on Children and Terrorism: Recommendations to the Secretary. 2003. http://health.mo.gov/emergencies/pediatrictoolkit/CommunityPlanningforChildren/NationalAdvisoryCommitteeonChildrenandTerrorismRecomm.pdf.Google Scholar
8. Stratton, SJ, Hastings, VP, Isbell, D, et al. The 1994 Northridge earthquake disaster response: the local emergency medical services agency experience. Prehospital Disaster Med. 1996;11(3):172-179.Google Scholar
9. Mattox, KL. Hurricanes Katrina and Rita: role of individuals and collaborative networks in mobilizing/coordinating societal and professional resources for major disasters. Critical Care. 2006;10(1):205.Google Scholar
10. Meadow, W, Lagatta, J, Andrews, B, et al. Just, in time: ethical implications of serial predictions of death and morbidity for ventilated premature infants. Pediatrics. 2008;121:732-740.Google Scholar
11. Lim, L, Rozycki, HJ. Postnatal SNAP-II scores in neonatal intensive care unit patients: relationship to sepsis, necrotizing enterocolitis, and death. J Matern Fetal Neonatal Med. 2008;21:415-419.Google Scholar
12. Antommaria, AHM, Sweney, J, Poss, WB. Critical appraisal of: triaging pediatric critical care resources during a pandemic: ethical and medical considerations. Pediatr Crit Care Med. 2010;11:396-400.Google Scholar
13. Leteurtre, S, Duhamel, A, Grandbastien, B, et al. Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children. CMAJ. 2010;182:1181-1187.Google Scholar
14. American Hospital Association. http://www.aha.org/aha/resource-center/Statistics-and-Studies/fast-facts.html. Published 2010. Accessed October 5, 2016.Google Scholar
15. United States Census Bureau. http://factfinder.census.gov/servlet/SAFFPopulation?_submenul=population_0&sse=on. Published 2009. Accessed October 5, 2016.Google Scholar
16. Cohen, RS. Regional disaster planning for neonatal intensive care disaster management. In: Arora R, Arora P, eds. Disaster Management – Medical Preparedness, Response and Homeland Security . Wallingford, Oxfordshire: CABI; 2013: 95-104.Google Scholar
17. Carbine, D, Cohen, R, Hopper, A, et al, Neonatal disaster preparedness tookit https://www.cpqcc.org/qi-toolkits/qi-toolkits-outside-resources/can-neonatal-disaster-preparedness-toolkit. Published 2015.Google Scholar
18. Cohen, R.S., Murphy, B., Ahern, T., Hackel, A. Disaster planning – triaging resource allocation in neonatology. J Investigative Med. 2010;58:188 (abstract #298).Google Scholar
19. Lin, A, Taylor, K, Wintch, S, et al. Triaging resource allocation for inpatient movement – TRAIN. NDMS; 2012.Google Scholar
20. National Domestic Preparedness Consortium. Pediatric disaster response and emergency preparedness. Published 2016. https://teex.org/documentsresources/MGT-439-Pediatric-Disaster-Response.pdf Google Scholar
21. Daniels, K, Oakeson, AM, Hilton, G. Steps toward a national disaster plan for obstetrics. Obstet Gynecol. 2014;124:154-158.Google Scholar
Supplementary material: File

Lin et al. supplementary material

Lin et al. supplementary material 1

Download Lin et al. supplementary material(File)
File 44 KB