EMERGENCY-MEDICINE IN THE PERSIAN-GULF-WAR .2. TRIAGE METHODOLOGY ANDLESSONS LEARNED

Study objective: To describe the conventional triage consequences of w ar zone casualties compared against expected NATO triage casualty esti mates; the influence of the Revised Trauma Score on triage sensitivity , and evaluation of physiological parameters considered potentially us eful to improved triage specificity and sensitivity. Study design: A r etrospective analysis of conventional triage and Revised Trauma Score data. Setting: A military field trauma center during the primary groun d assault into Kuwait. Type of participants: Four hundred sixty-one co alition and enemy force personnel who were triaged as casualties. Main results: Triage categories for coalition and enemy forces were remark ably similar, but deviated significantly (P<.001) from expected NATO t riage casualty estimates. Medical diagnoses were 6% and 11% of these f orces, respectively. Only 7% of enemy forces casualties and 2% of coal ition casualties required retriage. Neuropsychiatric triage categories identified 16 immediate casualties potentially at risk for post-traum atic stress. The Revised Trauma Score for triage failed to provide sig nificant triage sensitivity. Conclusions: Conventional triage is a use ful tool for war and conflict; it is experience dependent. Had the ant icipated number of casualties actually occurred in this war, we conclu de that the triage process would have benefitted from additional infor mation, probably physiologic information, to improve the sensitivity a nd specificity of our findings.