ABSTRACT
OBJECTIVES: Doctors and nurses suffer different mental health conditions following traumatic incidents. We systematically synthesized existing evidence on the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) and their associated risk factors among doctors and nurses following mass casualty incidents (MCIs). STUDY DESIGN: Systematic review. METHODS: Seven databases were searched (2010-2022) with peer-reviewed articles in English using the predefined keywords. Two reviewers screened the titles, abstracts, and full texts using the eligibility criteria and extracted data independently. We used the National Institutes of Health Quality Assessment Tools (NIH-QAT) and the Critical Appraisal Skills Programme checklist (CASP) to measure the quality appraisal of the included studies. RESULTS: A total of 5170 articles were retrieved, and 2512 articles were assessed by title and abstract (53 were eligible for full-text review). Finally, we included 19 studies. Most were assessed as of fair quality with a considerable risk of bias. PTSD was the highest-reported mental health condition. Nurses reported higher mental conditions, particularly PTSD. Two sets of risk factors (personal and workplace) are associated with anxiety, depression, and PTSD were found. CONCLUSIONS: MCIs have a significant impact on the mental health outcomes of emergency health workers. Preventive measures should be designed considering the high-risk group, personal, and organizational risk factors of mental health outcomes.
ABSTRACT
En los incidentes de múltiples víctimas (IMV), el triaje determina en gran medida los resultados finales en cuanto a asistencia sanitaria, organización y disminución de la morbimortalidad. La doctrina asistencial recomienda la realización del triaje ya en el ámbito prehospitalario para organizar la asistencia y evacuación de los heridos. Analizamos la aplicabilidad real de las recomendaciones en cuanto al triaje prehospitalario en IMV medianteuna revisión sistemática de la literatura científica utilizando como palabras clave "mass casualty triage" y "prehospital triaje". Se usan como fuentes de datos PubMed, Cochcran y las revistas EMERGENCIAS y Prehospital and Disaster Medicine. También se revisó la bibliografía de los artículos localizados. Se localizaron 561 artículos con los criterios de búsqueda, de los que 19 cumplían todos los criterios de inclusión. Es escasa la referencia que se hace a la metodología de triaje realizada, y en muchos de ellos se hace referencia explícita a la no realización del triaje. Existe una discrepancia entre la doctrina asistencial ante IMV y los datos publicados que puede ser debida a la dificultad de obtener datos en la escena del siniestro, a que las dificultades asistenciales no permiten aplicarla doctrina asistencial, o que ésta no es válida (AU)
Triage has a great effect on results in multiple-casualty incidents (MCIs), reducing morbidity and mortality through the allocation and organization of health care resources. Prehospital triage to organize care and evacuate casualties is a key theoretical premise in emergency health care. To analyze the applicability of prehospital triage recommendations for MCIs, we searched the literature using the search terms mass casualty triage and prehospital triage in the PubMed database, the Cochrane Library, and the journals Emergencias and Prehospital and Disaster Medicine. We also checked the reference lists of all articles found. Of a total of 561 titles located, 19 met the inclusion criteria. The articles offer little information on methods used for triage in MCIs and many explicitly state that no triage system was used. There is inconsistency between the theoretical approach to care applicable in MCIs and the reports of actual events, possibly because it is difficult to obtain data at the scene of the incident, because care giving interferes with the application of theory, or because the theory itself is invalid (AU)
