Consistency Analysis of JumpSTART Triage System and Injury Severity Score for Mass Casualties Including Children_West China Medical Journal

Authors：

SHENG Jie ,  HU Hai.

Department of Emergency, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

HU Hai., Email: 412649924@qq.com

Keywords：

JumpSTART檢傷分類程序; 損傷嚴重度評分; 群體傷

DOI：

10.7507/1002-0179.20130418

Video：

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目的　探討適用于兒童的JumpSTART檢傷分類程序在大型車禍所致的含兒童群體傷中，對患兒受傷嚴重程度評估的實踐意義。方法　回顧性分析2010年12月－2012年12月因大型車禍所致群體傷（3例以上傷員，至少含1例14歲以下兒童）就診的20例患兒的病歷資料。入急診時對患兒行JumpSTART檢傷分類程序，入院確診后行國際公認的能較準確反映傷情嚴重程度的損傷嚴重度評分（ISS）。比較兩種評估方法的一致性。結果　 JumpSTART檢傷分類程序與ISS評分一致性較好（Kappa=0.474，P=0.003）。結論　JumpSTART檢傷分類程序可在含兒童的群體傷醫療急救時，初步評估患兒傷情嚴重度，從而進行檢傷分類。

Citation： SHENG Jie,HU Hai.. Consistency Analysis of JumpSTART Triage System and Injury Severity Score for Mass Casualties Including Children. West China Medical Journal, 2013, 28(9): 1333-1335. doi: 10.7507/1002-0179.20130418 Copy

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2.	馮庚. 院前急救預案: 現場急救攻防策略[M]. 北京: 中國協和醫科大學出版社, 2010: 508-517.
3.	胡海, 杜鑫淼, 蔣臻, 等. 院前急救中兩種創傷評分法對急性酒精中毒合并外傷性顱內出血患者的評估作用[J]. 華西醫學, 2009, 24(8): 1929-1931.
4.	胡海, 張建成, 曹鈺, 等. APACHEII評分在心肺復蘇自主循環恢復患者早期死亡預測中的作用[J]. 中國急救復蘇與災害醫學雜志, 2010, 5(3): 230-231.
5.	Mace SE, Bern AI. Needs assessment: are disaster medical assistance teams up for the challenge of a pediatric disaster?[J]. Am J Emerg Med, 2007, 25(7): 762-769.
6.	Romig LE. Pediatric triage. A system to JumpSTART your triage of young patients at MCIs[J]. JEMS, 2002, 27(7): 52-58, 60-63.
7.	Asaeda G. The day that the START triage system came to a STOP: observations from the world trade center disaster[J]. Acad Emerg Med, 2002, 9(3): 255-256.
8.	趙偉. 災害救援現場的檢傷分類方法-評述院外定性與定量法[J]. 中國急救復蘇與災害醫學雜志, 2007, 2(5): 291-294.
9.	程學明, 陳維庭, 李永清. 介紹創傷評分的最新版AIS-90[J]. 中華創傷雜志, 1999, 8(2): 122-123.
10.	Greenspan L, McLellan BA, Greig H. Abbreviated injury scale and injury severity score: a scoring chart[J]. J Trauma, 1985, 25(1): 60-64.
11.	Sasser SM, Hunt RC, Sullivent EE, et al. Guidelines for field triage of injured patients. Recommendations of the national expert panel on field triage[J/OL]. MMWR, 2009, 58(RR01): 1-35[2013-05-25]. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5801a1.htm.
12.	王潔貞, 趙躍進, 馬會妍, 等. Kappa統計量及其應用[J]. 中國衛生統計, 1995, 12(6): 49-50.
13.	羊建華, 唐元萍. 637例兒童意外傷害原因分析及預防探討[J]. 右江民族醫學院學報, 2008, 30(3): 447-448.
14.	Hegazy SM, El-Sayed LA, Ahmed TY. Avoiding pitfalls in trauma triage: effect of nursing staff development[J]. N Y Sci J, 2012, 5(1): 44-52.
15.	馮庚. 院前急救時的檢傷分類-定量分析方法及程序[J]. 中國全科醫學, 2012, 15(2): 575-576.
16.	Cicero MX, Auerbach MA, Zigmont J, et al. Simulation training with structured debriefing improves residents’ pediatric disaster triage performance[J]. Prehosp Disaster Med, 2012, 27(3): 239-244.
17.	Baker SP, O’Neill B, Haddon W, et al. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care[J]. J Trauma, 1974, 14(3): 187-196.
18.	尹國強, 郝進芳, 干建新, 等. 多發傷損傷嚴重度評分與C反應蛋白及其血清酶學的相關性分析[J]. 中華創傷雜志, 2002, 18(7): 434-435.
19.	殷剛, 馬建東, 丁磊, 等. 518例骨盆骨折患者生存概率基本特征分析[J]. 寧夏醫科大學學報, 2012, 34(12): 1294-1296.
20.	孟新科. 急危重癥評分[M]. 北京: 人民衛生出版社, 2008: 60-63.
21.	Jenkins JL, McCarthy ML, Sauer LM, et al. Mass-casualty triage: time for an evidence-based approach[J]. Prehosp Disaster Med, 2008, 23(1): 3-8.

1. 　Lenert LA, Kirsh D, Griswold WG, et al. Design and evaluation of a wireless electronic health records system for field care in mass casualty settings[J]. J Am Med Inform Assoc, 2011, 18(6): 842-852.
2. 　馮庚. 院前急救預案: 現場急救攻防策略[M]. 北京: 中國協和醫科大學出版社, 2010: 508-517.
3. 　胡海, 杜鑫淼, 蔣臻, 等. 院前急救中兩種創傷評分法對急性酒精中毒合并外傷性顱內出血患者的評估作用[J]. 華西醫學, 2009, 24(8): 1929-1931.
4. 　胡海, 張建成, 曹鈺, 等. APACHEII評分在心肺復蘇自主循環恢復患者早期死亡預測中的作用[J]. 中國急救復蘇與災害醫學雜志, 2010, 5(3): 230-231.
5. 　Mace SE, Bern AI. Needs assessment: are disaster medical assistance teams up for the challenge of a pediatric disaster?[J]. Am J Emerg Med, 2007, 25(7): 762-769.
6. 　Romig LE. Pediatric triage. A system to JumpSTART your triage of young patients at MCIs[J]. JEMS, 2002, 27(7): 52-58, 60-63.
7. 　Asaeda G. The day that the START triage system came to a STOP: observations from the world trade center disaster[J]. Acad Emerg Med, 2002, 9(3): 255-256.
8. 　趙偉. 災害救援現場的檢傷分類方法-評述院外定性與定量法[J]. 中國急救復蘇與災害醫學雜志, 2007, 2(5): 291-294.
9. 　程學明, 陳維庭, 李永清. 介紹創傷評分的最新版AIS-90[J]. 中華創傷雜志, 1999, 8(2): 122-123.
10. 　Greenspan L, McLellan BA, Greig H. Abbreviated injury scale and injury severity score: a scoring chart[J]. J Trauma, 1985, 25(1): 60-64.
11. 　Sasser SM, Hunt RC, Sullivent EE, et al. Guidelines for field triage of injured patients. Recommendations of the national expert panel on field triage[J/OL]. MMWR, 2009, 58(RR01): 1-35[2013-05-25]. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5801a1.htm.
12. 　王潔貞, 趙躍進, 馬會妍, 等. Kappa統計量及其應用[J]. 中國衛生統計, 1995, 12(6): 49-50.
13. 　羊建華, 唐元萍. 637例兒童意外傷害原因分析及預防探討[J]. 右江民族醫學院學報, 2008, 30(3): 447-448.
14. 　Hegazy SM, El-Sayed LA, Ahmed TY. Avoiding pitfalls in trauma triage: effect of nursing staff development[J]. N Y Sci J, 2012, 5(1): 44-52.
15. 　馮庚. 院前急救時的檢傷分類-定量分析方法及程序[J]. 中國全科醫學, 2012, 15(2): 575-576.
16. 　Cicero MX, Auerbach MA, Zigmont J, et al. Simulation training with structured debriefing improves residents’ pediatric disaster triage performance[J]. Prehosp Disaster Med, 2012, 27(3): 239-244.
17. 　Baker SP, O’Neill B, Haddon W, et al. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care[J]. J Trauma, 1974, 14(3): 187-196.
18. 　尹國強, 郝進芳, 干建新, 等. 多發傷損傷嚴重度評分與C反應蛋白及其血清酶學的相關性分析[J]. 中華創傷雜志, 2002, 18(7): 434-435.
19. 　殷剛, 馬建東, 丁磊, 等. 518例骨盆骨折患者生存概率基本特征分析[J]. 寧夏醫科大學學報, 2012, 34(12): 1294-1296.
20. 　孟新科. 急危重癥評分[M]. 北京: 人民衛生出版社, 2008: 60-63.
21. 　Jenkins JL, McCarthy ML, Sauer LM, et al. Mass-casualty triage: time for an evidence-based approach[J]. Prehosp Disaster Med, 2008, 23(1): 3-8.

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Consistency Analysis of JumpSTART Triage System and Injury Severity Score for Mass Casualties Including Children

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