| 词条 | JumpSTART triage |
| 释义 |
JumpSTART was created in 1995 by Dr. Lou Romig, a pediatric emergency and disaster physician working at Miami Children's Hospital.[2] After seeing the effects of Hurricane Andrew on the pediatric population, Dr. Romig became interested in pediatric disaster medicine and developed the JumpSTART tool. JumpSTART was modified in 2001.[2] Triage categoriesLike START, JumpSTART sorts patients into four categories:[1] {{legend inline|Red|Immediate}}: Life-threatening injury; needs medical attention within the next hour {{legend inline|Yellow|Delayed}}: Non-life-threatening injuries; needs medical attention, but treatment can be delayed a few hours {{legend inline|Green|Minor}}: Minor injuries; may need medical attention in the next few days ("the walking wounded") {{legend inline|Black|Deceased or expectant}}: Deceased, or injuries so severe that life-saving treatment cannot be provided with the resources available The JumpSTART algorithmStep 1: Identify ambulatory patientsAs with START, the triage clinician begins by instructing everyone who can walk to move to a designated area for treatment. All patients who are able to do this are immediately tagged green (minor). These patients are then fully triaged by a clinician assigned to the green area (secondary triage). In the JumpStart system, infants are evaluated first in secondary triage, using the entire JumpStart algorithm. Other children who did not walk on their own, but were carried to the treatment area, are evaluated next.[1] Step 2: Is the patient breathing?YesIf the patient is breathing, the clinician proceeds to step 3. NoAs with START, an airway maneuver is first attempted. If the child starts breathing on their own, they are triaged red (immediate).[1] However, unlike START, patients who do not have a spontaneous return of respirations following an airway maneuver are not immediately triaged Black. First the clinician feels for a peripheral pulse. If the child is apneic with no peripheral pulse, they are triaged black (deceased/expectant).[1] If the child does have a palpable peripheral pulse, the clinician delivers five assisted ventilations. If the child remains apneic, they are triaged black. If the child has a return of spontaneous respirations, they are triaged red.[1] Step 3: Assess respiratory rate, perfusion, and mental statusThe child is triaged red if:[1]
To be triaged yellow, the child must:[1]
Literature reviewAs of 2016, there have been no studies of JumpSTART's validity or reliability in actual mass-casualty settings, though JumpSTART's discriminant validity has been established.[3] Within the medical literature, the existing studies of JumpSTART generally examine its use in training or simulated MCI settings. Several studies have found that medical providers easily learn the JumpSTART algorithm. For example, a study of prehospital and nursing personnel found that participants showed improvements in their ability to triage pediatric patients which were maintained over a 3-month period after training ceased.[4] Similarly, a 2013 study found that medical residents in all postgraduate years easily learned the JumpSTART algorithm, with high inter-rater reliability in individual patient triage decisions. However, while reliability was high in patients with head injuries, it was low in ambulatory patients.[5] In a simulated pediatric mass casualty incident, JumpSTART was found to perform equally as well as SALT triage, which has been proposed as a new national standard for mass-casualty triage. However, JumpSTART was significantly faster than SALT, requiring eight seconds less per patient.[6] However, a 2006 study by two physicians in a South African emergency department was critical of the JumpSTART system. The study examined how four different tools would have performed if used to triage pediatric patients that presented at the authors' emergency department. The authors compared the START and JumpSTART systems with two other pediatric triage tools: the Pediatric Triage Tape and Care Flight.[7] The study reported: None of the tools showed high sensitivity and specificity. ... [T]he JumpSTART and START scores had very low sensitivities, which meant that they failed to identify patients with serious injury, and would have missed the majority of seriously injured casualties in the models of major incidents.[7] Further study is needed to evaluate JumpSTART's validity and reliability, particularly in real-life patient settings.[3][4][5] See also
References1. ^1 2 3 4 5 6 7 {{cite web |url=https://chemm.nlm.nih.gov/startpediatric.htm |title=JumpSTART Pediatric Triage Algorithm |author= |date=June 25, 2011 |website=Chemical Hazards Emergency Medical Management |publisher=United States Department of Health and Human Services |accessdate=February 9, 2016 |quote=}} 2. ^1 {{cite journal |author=Romig LE 2002 |title=Pediatric triage: A system to JumpSTART your triage of young patients at MCIs |url= |journal=Journal of Emergency Medical Services |publisher= |volume=27 |issue=7 |pages=52–8, 60–3 |doi= |pmid=12141119 }} 3. ^1 {{cite journal |vauthors=Jenkins JL, McCarthy ML |title=Mass-Casualty Triage: Time for an Evidence-Based Approach |url= http://c.guionnet.free.fr/Mémoire%202012/Biblio/jenkins.pdf |journal=Prehospital Disaster Medicine |publisher= |volume=23 |issue=1 |pages=3–8|doi= 10.1017/s1049023x00005471|accessdate=February 9, 2016|display-authors=etal}} 4. ^1 {{cite journal |author=Sanddal TL; Loyacono T 2004 |title=Effect of JumpSTART Training on Immediate and Short-Term Pediatric Triage Performance |url= |journal=Pediatric Emergency Care |publisher=Lippincott Williams & Wilkins, Inc. |volume=20 |issue=11 |pages=749–753 |doi= |accessdate=February 9, 2016|display-authors=etal}} 5. ^1 {{cite journal |author=Cicero MX; Riera A 2013 |title=Design, Validity, and Reiability of a Pediatric Resident JumpSTART Disaster Triage Scoring Instrument |url= |journal=Academic Pediatrics |publisher=Elsevier, Inc. |volume=13 |issue=1 |pages=48–54 |doi=10.1016/j.acap.2012.09.002 |display-authors=etal}} 6. ^{{cite journal |author=Jones N; White ML 2014 |title=Randomized Trial Comparing Two Mass Casualty Triage Systems (JumpSTART versus SALT) in a Pediatric Simulated Mass Casualty Event |url= |journal=Prehospital Emergency Care |publisher= |volume=18 |issue=3 |pages=417–423 |doi=10.3109/10903127.2014.882997 |display-authors=etal}} 7. ^1 {{cite journal |author=Wallis LA; Carley S 2006 |title=Comparison of paediatric major incident primary triage tools |url= |journal=Emergency Medicine Journal |publisher= |volume=23 |issue= |pages=475–478|doi=10.1136/emj.2005.032672 |pmc=2564353}} External links
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