Putting triage theory into practice at the scene of multiple casualty vehicular accidents: the reality of multiple casualty triage

This presentation highlights the findings of a project that explored the nexus between theoretical understandings of the triage process, and how triage is actually performed. This presentation was delivered at a number of national and international forums. For the project, information was collected from ambulance Paramedics from South Australia and the Australian Capital Territory, through focus groups and interviews. This project was supported by a grant from the ACT NRMA Road Safety Trust.






Reference: Arbon P, Zeitz K, Ranse J, Wren H, Driscoll K, Elliott R. The realities of triage; paper presented at the 6th International Conference for Emergency Nurses, Melbourne, Australia, 12th October 2007.

Reference: Arbon P, Zeitz K, Ranse J, Wren H, Driscoll K, Elliott R. Multi-casualty triage – putting triage theory into practice at the scene of multiple casualty vehicular accidents; paper presented at the15th World Congress on Disaster and Emergency Medicine, Amsterdam, the Netherlands, 14th May 2007.

Reference: Arbon P, Zeitz K, Ranse J, Wren H, Driscoll K, Elliott R. Putting triage theory into practice at the scene of multiple casualty vehicular accidents: the reality of multiple casualty triage; paper presented at the ACT Public Health Forum, Canberra, Australia, 16th November 2006.

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Thesis: In-hospital resuscitation: Graduate nurses’ lived experience in the non-critical care environment – a hermeneutic phenomenological approach

In resuscitation teachings to newly Registered Nurses, we place an emphasis on process of Airway, Breathing and Circulation - in reality this is not their role. In a resuscitation, the newly Registered Nurse will be scribing, drawing-up medications and scouting for equipment. As such, the in-hospital training of such cohorts needs to be addressed to meet the realities of the newly Registered Nurses role. This example is one of a number of findings related to my thesis, which was completed in partial fulfilment for the award: Master of Critical Care Nursing.

Reference: Ranse J. In-hospital resuscitation: graduate nurses’ lived experience in the non-critical care environment – a hermeneutic phenomenological approach [thesis]. University of Canberra. 2006.

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Putting triage theory into practice at the scene of multiple casualty vehicular accidents: the reality of multiple casualty triage

This research report highlights the findings of a project that explored the nexus between theoretical understandings of the triage process, and how triage is actually performed. Data was collected from ambulance Paramedics from South Australia and the Australian Capital Territory. This project was supported by a grant from the ACT NRMA Road Safety Trust. 

Reference: Arbon P, Zeitz K, Ranse J, Wren H, Driscoll K, Elliott R. Putting triage theory into practice at the scene of multiple casualty vehicular accidents: the reality of multiple casualty triage. [research report - available free in full-text].

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Exploring the volunteer first aiders’ experience post-resuscitation

Objectives: This study aims to identify themes associated with St John volunteer first aiders’ post-resuscitation experience following an out-of-hospital sudden cardiac arrest, and to make suggestions for future practice in education and research.

Methods: This study was exploratory and descriptive in design, utilising a single focus group as a means of data collection. All five participants from a single resuscitation event participated in the focus group. The focus group was electronically recorded and transcribed verbatim. The results were then thematically analysed.

Findings: The focus group participants described four themes associated with successful resuscitation of a casualty following sudden cardiac arrest. These themes were: postresuscitation casualty management; interactions with health care professionals; critical incident stress management and learning about the casualty’s outcome.

Discussion: Education of first aid service providers should include post-resuscitation casualty management, this could be achieved by including the chain of survival in its entirety rather than the DRABCD (danger, response, airway, breathing, circulation and defibrillation) resuscitation action plan only. Similarly, ambulance paramedics require an understanding of semi-automatic external defibrillators as used by first aid service providers. In particular, the limitations of semi-automatic external defibrillators should be included in education programs for ambulance paramedics and emergency department staff. Finally, first aid service providers should implement formal mechanisms to provide feedback to participants regarding casualty outcomes following a critical event.

Reference: Ranse J, Burke B. Exploring the volunteer first aiders’ experience post-resuscitation. Journal of Emergency Primary Health Care. 2006;4(3):10p

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Cardiac arrest: can the in-hospital chain of survival be improved?

Survival from cardiac arrest decreases between 7 and 10% each minute defibrillation is delayed. Within the pre-hospital care environment, public access defibrillation programs and first-responders utilise semi-automatic external defibrillators to effectively increase survival following cardiac arrest from approximately 10% to approximately 60%. However, survival from an in-hospital cardiac arrest remains at approximately 10% despite the introduction of medical emergency teams. This discussion paper examines various methods to increase the in-hospital survival rate following a cardiac arrest, such as the implementation of first-responder semi-automatic external defibrillator programs and increasing education standards in basic and advanced cardiac life support.

Reference: Ranse J. Cardiac arrest: can the in-hospital chain of survival be improved? Australasian Emergency Nursing Journal. 2006;9(1):23-27.

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