Remote Scene Size-up Using an Unmanned Aerial Vehicle in a Simulated Mass Casualty Incident.
Prehospital Emergency Care · 2018-08-21 · Observational study
Abstract
INTRODUCTION: The scene-size-up is a crucial first step in the response to a mass casualty incident (MCI). Unmanned aerial vehicles (UAV) may potentially enhance the scene-size-up with real-time visual feedback during chaotic, evolving or inaccessible events. We performed this study to test the feasibility of paramedics using UAV video from a simulated MCI to identify scene hazards, initiate patient triage, and designate key operational locations. METHODS: We simulated an MCI, including 15 patients plus 4 hazards, on a college campus. A UAV surveyed the scene, capturing video of all patients, hazards, surrounding buildings and streets. We invited attendees of a provincial paramedic meeting to participate. Participants received a lecture on Sort-Assess-Lifesaving Interventions-Treatment/Transport (SALT) Triage and MCI scene management principles. Next, they watched the UAV video footage. We directed participants to sort patients according to SALT Triage Step One, identify injuries, and to localize the patients within the campus. Additionally, we asked them to select a start point for SALT Triage Step Two, identify and locate hazards, and designate locations for an Incident Command Post, Treatment Area, Transport Area and Access/Egress routes. The primary outcome was the number of correctly allocated triage scores. RESULTS: Ninety-six individuals participated. Mean age was 35 years (SD 11); 46% (44) were female and 49% (47) were Primary Care Paramedics. Most participants (79; 82%) correctly sorted at least 12 of 15 patients. Increased age was associated with decreased triage accuracy [-0.04(-0.07, -0.01); p = 0.031]. Fifty-two (54%) correctly localized 12 or more patients to a 27 × 20m grid area. Advanced paramedic certification, and local residency were associated with improved patient localization [2.47(0.23,4.72); p = 0.031], [3.36(1.10,5.61); p = 0.004]. The majority of participants (70; 81%) chose an acceptable location to start SALT Triage Step Two and 75 (78%) identified at least 3 of 4 hazards. Approximately half (53; 56%) of participants appropriately designated 4 or more of 5 key operational areas. CONCLUSION: This study demonstrates the ability of UAV technology to remotely facilitate the scene size-up in an MCI. Additional research is required to further investigate optimal strategies to deploy UAVs in this context.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Drones · Mass casualty triage · Paramedics & EMTs · Triage instruments
Related articles
- A Drone-Integrated Artificial Intelligence-Based System for Mass-Casualty Triage and Remote Monitoring. (Prehosp Disaster Med, 2026)
- The Use of Field Triage in Disaster and Mass Casualty Incidents: A Survey of Current Practices by EMS Personnel. (Prehosp Emerg Care, 2018)
- Comparison of START and SALT triage methodologies to reference standard definitions and to a field mass casualty simulation. (Am J Disaster Med, 2017)
- Randomized trial comparing two mass casualty triage systems (JumpSTART versus SALT) in a pediatric simulated mass casualty event. (Prehosp Emerg Care, 2014)
- Virtual Reality Simulation for Assessment of Hemorrhage Control and SALT Triage Performance: A Comparison of Prehospital to In-Hospital Emergency Responders. (Prehosp Disaster Med, 2025)
- Primary mass casualty incident triage: evidence for the benefit of yearly brief re-training from a simulation study. (Scand J Trauma Resusc Emerg Med, 2018)