Hospital Triage Tools Used During Disaster Events in Canada Over the Last 40 Years: A Scoping Review

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Introduction: A mass casualty incident (MCI) is a sudden onset event that can generate many patients with the potential to overwhelm healthcare resources. Many Canadian hospitals plan to use disaster-specific triage tools during an MCI, rather than routine procedures, despite a lack of studies. It is not known whether these alternate triage tools have ever been utilized in actual Canadian MCIs. This study sought to discover what triage strategies have been recorded and their frequency of use. Methods: A scoping review of scientific databases and the grey literature was conducted to find published material regarding the triage strategy employed by the responding hospital(s) during real MCI events in Canada over the last 40 years (i.e., January 1, 1983, to December 31, 2022). A survey of healthcare providers was also administered to elicit further information regarding triage practices. Results: The database searches identified 279 reports; 32 underwent full manuscript review, and 2 were included in the study. The grey literature search yielded 28 reports; 23 were fully reviewed, and 1 was included. The grey literature search also identified 22 events that triggered MCI alerts at Canadian hospitals, and contacts for 15 of these events were invited to participate in the survey. Survey data were retrieved from 6 events (40% response rate). Nine separate disaster events were reported on in total. Six of these events reported a pre-existing hospital MCI triage plan, with 5 (83%) citing intent to use an alternate triage system. During the actual event, only 1 (12.5%) reported using an alternate triage strategy. Conclusion: It may be appropriate to disregard alternate disaster triage tools for hospital triage and use routine procedures, saving valuable time and financial resources. The creation of a national repository of disaster responses impacting healthcare delivery in Canada should be strongly considered.

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