Introduction: Children with medical complexity (CMC) are defined as disabled children who are on a ventilator or require medical care to carry out daily life under Article 56 of the Child Welfare Law in Japan. In Japan, it is estimated that there were about 20,000 children aged 0 to 19 living at home under medical care in 2023. The mortality rate of persons with disabilities in the Great East Japan Earthquake was twice that of healthy persons, and it was reported that the mortality rate was higher among those living at home than among medical facility residents. Responding to disasters for CMC has become an urgent issue. Methods: Primary triage was performed based on information on the normal conditions of CMC aged 1 to 16 who were treated at Tottori University Hospital in 2018. In this study, we triaged 69 children with medical care needs aged 1 to 16 years under normal conditions using Jump START and START methods. Results: There were 69 affected children (boys: girls 39: 30). The median age was 9.0. The reasons for medical healthcare needs were cardiac disease in 14, congenital anomaly syndrome in 13, perinatal disorders in 12, chromosomal abnormalities in 10, sequelae from trauma in 4, muscle diseases in 3, otolaryngological diseases in 3, metabolic diseases in 3, respiratory diseases in 2, and oncological diseases in 2. The triage results showed that one was in the expectant group, 24 were in the immediate treatment group, 12 were in the delayed treatment group, and 32 were in the minor group. Among the children triaged to Category III, 14 required oxygen administration, including 4 with noninvasive ventilators and 1 with a tracheostomy. Conclusion: It is difficult to triage CMC appropriately using the START method and Jump START method, and it is necessary to develop a triage method specifically for CMC.
Nakamura et al. (Sun,) studied this question.