Comparison of Triage Accuracy Between EMS and Healthcare Personnel Using START Triage: A Case Study of the Eastern Region Disaster Drill

Introduction: Disaster management is an ongoing planning process aimed at reducing uncertainty and mitigating hazards in dangerous situations. The disaster cycle is divided into four interdependent phases: mitigation, preparedness, response, and recovery. Although mitigation is the most crucial, given the frequent disasters in Eastern Taiwan in recent years, there has been increased emphasis on preparedness. Training exercises have been implemented to improve response capabilities and reduce casualties in actual disaster scenarios. On October 15, 2024, a disaster medical team drill was held in Taitung, simulating a shallow 7.0-magnitude earthquake in a mountainous region. Medical teams, formed by two distinct teams, mainly managed trauma cases. Methods: This prospective observational study had a mild-to-severe injury ratio of 5:3:2. Patients were assigned to either Station A, staffed by advanced emergency medical technicians (EMTs), or Station B, staffed by hospital nurses. Both groups had completed START triage and disaster medical training. Each triaged the 30 patients, and accuracy rates were compared across roles. Results: Statistical analysis revealed that Station A handled 22 patients with an accuracy of 68.2%, whereas Station B handled 26 patients with an accuracy of 57.7%. Conclusion: Although literature suggests that healthcare personnel generally have higher triage accuracy than EMTs, EMTs perform triage faster, making them better suited for rapid disaster response. In this study, EMTs showed higher accuracy than nurses, potentially due to EMTs’ frequent training in START, unlike nurses, who typically use a five-level triage system. Thus, it is recommended that EMTs lead triage in disaster scenarios.