The Sacco Triage Method (STM) is an evidence based outcome driven triage and resource management system that maximizes expected survivors in consideration of the timing, availability and capability of transport and treatment resources. Based on a simple age adjusted physiological score (i.e. respiratory rate, pulse, best motor response) that is computed routinely on every trauma patient and that is correlated to survival probability and deterioration, triage decisions are made in response to the specific type and size and location of incident, and the resources that can be brought to bear on its resolution. STM explicitly prioritizes and tracks resource utilization and expected patient outcome during an incident, creates a triage and regional resource action plan, and provides real time situation and status reports. STM provides evidence based decision support for efficient medevac dispatching. (click for details)
Important Updates/Publications …
The editorial Science and Evidence Based Considerations for Fulfilling the SALT Triage Framework published in Disaster Medicine and Public Health Preparedness (March 2010)
STM is the only method that can fulfill the SALT triage framework."
This manuscript details how STM provides the methodology and includes the features suggested by SALT, and how color coded methods cannot satisfy the SALT framework. more info...
Evidence–based medevac dispatching shown to eliminate 60% of flights while reducing mortality
Eliminates 60% of flights and reduces mortality."
Through an extension of the Sacco Triage Method to include ACS trauma center criteria, the number of medevac flights could be reduced by more than 60%, while patient outcome can actually improve through evidence based medevac dispatch. The reduction potential is consistent with the industry’s long standing belief that you need to overtriage by 50%, in order to maintain an undertriage rate of less than 5%. This application reduces overtriage, tightens undertriage, and eliminates the strong bias against senior and geriatric patients in the use of air transport. more info...
Landmark Operational Comparison of START and STM in Mass Casualty Exercises published in the Journal of Trauma (July 2010).
STM proven faster, more accurate, and better at prioritizing than START"
Parallel 99 patient exercises comparing START and STM showed STM to be faster, more accurate, and better at prioritizing patients. Under START, only 2 of the 13 most serious patients were transported on the first 13 ambulances and the three most serious left by bus nearly an hour later. Under STM, the 12 of the 13 most serious left in the first 6 ambulances. more info...
Application of a New Resource Constrained Triage Method to Military-Aged Victims published in Military Medicine.
Combat simulations show up to a 18-fold increase in survivors"
December 2009. This research extends the STM to military aged patients for blunt, penetrating, and blast overpressure trauma, and compares the outcome performance of STM to START in Iraqi combat simulations, showing life saving increases ranging from 20% to 18 fold increase. more info...
The Letter to the Editor Does START Triage Work? The Answer is Clear! published in the Annals of Emergency Medicine (June 2010).
START proven ineffective"
The paper comments on and extends the conclusions of Kahn (et al) in their retrospective analysis of the performance of START in the Glendale California train crash.
Benefits of STM
(click Benefit to view)