Mass casualty triage knowledge of military medical personnel

During battlefield and mass casualty incidents, triage has been traditional ly performed by many different personnel, including medics, nurses, dentist s, and physicians. The objective of this study was to determine which milit ary medical providers are most knowledgeable in mass casualty triage, The d esign was a prospective, written, timed, case-based examination of triage k nowledge. Participants were volunteers from the active duty medical (physic ian), dental, nursing, and enlisted corps of the three military services. S ubjects completed a 16-minute written examination consisting of seven cases in each of three simulated mass casualty scenarios: combat; nuclear, biolo gical, and chemical; and humanitarian. Tests were taken anonymously, althou gh demographic data on medical specialty, training, and experience were col lected. Participants were instructed to classify the cases using the NATO c ategories of immediate, delayed, minimal, or expectant. Scores were tabulat ed according to two grading scales: an absolute scale of number correct, an d a weighted scale amplifying gross misclassifications. Median scores betwe en groups were tested pairwise using the Kruskal-Wallis one-way analysis of variance with p less than or equal to 0.05, Statistically significant diff erences were noted between the highest and lowest scoring groups in each sc enario. Our conclusion is that among the subject groups tested, physicians were best at mass casualty triage. Dentists, nurses, and medics scored prog ressively less well on our examination.