Triage Applicable in Management of Victims from Explosions in Mosul, Iraq: Prospective Study

Abstract

The triage system can independently analyze and predict accident data, contributing to improving the mortality rate. The purpose of this study was to evaluate accident victims injured in explosion accidents whether ambulance crews appropriately triage trauma patients. This prospective study included 93 patients with blast injuries who presented directly to the emergency department in Al-Jumhori Teaching Hospital in Mosul, Iraq. Data of transport vehicle type, and duration from event to arrival at the emergency department were recorded. The patients were sorted into four groups as follows: small, treated with simple first aid, and discharged from the hospital. The intermediate group was treated with resuscitation, investigation, and monitoring of clinical signs. Severe combination may require immediate surgical intervention. The last group was placed in a quiet room to die peacefully. Most patients were labeled green with an incidence of 43% and red with 19% of patients. Ambulance transported approximately 66.7% of patients, but this method of transport has been associated with a higher mortality rate. Military vehicles were transported at a rate of only 16.1%, they were associated with higher morbidity rate. In the first 20 minutes of the incident, approximately 61.3% of patients presented to the emergency department. The overall morbidity and mortality rates were 4.3% and 7.5%, respectively. The higher mortality rate was associated with a period ranging from 21 to 30 minutes after the accident. In conclusion, triage is an essential component in the context of mass incident response planning, requiring high decision-making skills based on the ability to quickly and accurately identify relevant information during the clinical assessment of patients.