Cureus · 2026
Evaluation of Nurse-Led Sono-Triage in Identifying the Under-Triage Rate Among Yellow-Triage Patients During Mass Casualty Incidents at a Level 1 Trauma Center in India.
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Sinha Geeta, Bhoi Sanjeev, Sinha Tejprakash, Sundriyal Shakuntala, Kondru Shyamala, Vazhayil Shoukkathali, Magan Radhika
Аннотация
BACKGROUND: Triage is critical during mass casualty incidents (MCIs). Under-triage during MCIs using existing triage tools may lead to errors in making critical treatment decisions. The point-of-care ultrasound has been used during MCIs to diagnose hemoperitoneum, pneumothorax, long bone fractures, cardiac tamponade, and inferior vena cava (IVC), with good sensitivity and specificity.
OBJECTIVE: We explored the impact of nurse-led sono-triage in identifying the under-triage rate among yellow triage patients and inter-rater agreement among nurse performers during MCIs.
METHODS: This was a retrospective observational study of four MCIs during Holi festivals encountered at the emergency department of a level one trauma centre in India. After undergoing training, 10 nurses performed extended focused assessment by sonography in trauma (E-FAST) of yellow triaged patients. The findings were recorded and analyzed.
RESULTS: Sono triage was done in 438 patients. Eight patients were E-FAST positive, and 430 E-FAST negative patients. These eight patients (1.8%) were then triaged as red and categorized as under-triaged. The interrater agreement between the nurse performers and the radiologist was 100%.
CONCLUSION: Sono-triage was able to estimate the under-triage rate among yellow triage patients during MCIs. The nurses who performed sono-triage had a good inter-rater agreement with the radiologist. Nurses may be utilized as a task-sharing model to do sono-triage during MCIs.
OBJECTIVE: We explored the impact of nurse-led sono-triage in identifying the under-triage rate among yellow triage patients and inter-rater agreement among nurse performers during MCIs.
METHODS: This was a retrospective observational study of four MCIs during Holi festivals encountered at the emergency department of a level one trauma centre in India. After undergoing training, 10 nurses performed extended focused assessment by sonography in trauma (E-FAST) of yellow triaged patients. The findings were recorded and analyzed.
RESULTS: Sono triage was done in 438 patients. Eight patients were E-FAST positive, and 430 E-FAST negative patients. These eight patients (1.8%) were then triaged as red and categorized as under-triaged. The interrater agreement between the nurse performers and the radiologist was 100%.
CONCLUSION: Sono-triage was able to estimate the under-triage rate among yellow triage patients during MCIs. The nurses who performed sono-triage had a good inter-rater agreement with the radiologist. Nurses may be utilized as a task-sharing model to do sono-triage during MCIs.