Prehospital triage algorithms for mass casualty incidents in Germany and its neighboring countries – A survey of rescue services and comparison of european recommendations for triage algorithms and its potential implications

Introduction: Preclinical triage is vital during mass casualty incidents(MCI). Several triage algorithms are in use internationally, with intentions to consent algorithms for increased quality[1]. In Germany, specific triage categories can legally only be determined by a doctor, which limits the use of international algorithms preclinical. This study examined the preclinical triage methods in Germany and compared them with those of neighboring countries.

Materials and Methods: 212 medical directors of rescue services in Germany were surveyed using Unipark EFS Survey Software. The survey was sent out on 25.07.2024 and was not repeated. A literature search was done to identify triage systems in other European countries.

Results: The response rate was 34,4%(n=73). 98,6% use preclinical triage algorithms. 53,4% use mSTART, 24,6% use PRIOR (tailored for the German healthcare system), 4% use START, 1.4% use SALT, 18% use others. The literature revealed that France, Austria, Poland, and Czechia suggest using START. Switzerland and the Netherlands use their own algorithms[2;3].

Conclusion: Most rescue services in Germany use a triage algorithm, often the government's recommendation, mSTART. However, existing differences within Germany and neighboring countries could hinder triage in translational MCIs. Different categories and approaches could lead to various prioritization. Intentions to harmonize triage, such as in the US, should be considered.

Lerner EB et al.(2011).Mass casualty triage: an evaluation of the science and refinement of a national guideline. Disaster Med Public Health Prep.5(2):129-37. doi: 10.1001/dmp.2011.39.Becker, D et al.(2022).MANV-H Algorithmus – Ein Algorithmus zur Triage bei einem Massenanfall von Verletzten für den Hospitalisationsraum. Version 4Smits M et al.(2022).Reliability and validity of the Netherlands Triage Standard in emergency care settings: a case scenario study. Emerg Med J.39(8):623-627. doi: 10.1136/emermed-2021-211359.

No