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The SALT and START Triage System for Classifying Patient Acuity Level: A Systematic Review

Purwadi, Hendri - Personal Name; Breaden, Katrina - Personal Name; McCloud, Christine - Personal Name; Pranata, Satriya - Personal Name;

Background: Two common triage systems have been widely used in mass casualty incidents (MCIs) and disaster situations, namely START (simple triage algorithm and rapid treatment) and SALT (sort, assess, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over the START triage system.
Purpose: This systematic review aims to compare the accuracy of the SALT and START triage systems in disaster and MCI settings.
Methods: The literature was searched using a systematic search strategy for articles published from 2009 to 2020 in the Medline, CINAHL, Web of Science, Scopus, PubMed, ProQuest databases, and the grey literature. This review included simulation-based and medical record-based studies investigating the accuracy and applicability of the SALT and START triage systems in adult and child populations during MCIs and disasters. All types of studies were included. The PRISMA flowchart was used to retain the articles, and the Joanna Briggs Institute critical appraisal tools were used to assess the quality of the reviewed studies.
Results: Of 1,450 articles identified in the search, 10 articles were included. It was found that the START triage system had a wide range and inconsistent levels of accuracy (44% to 94.2%) compared to the SALT triage system (70% to 83%). The under-triage error of the START triage system ranged from 2.73% to 20%, which was slightly lower than the SALT triage system (7.6% to 23.3%). The over-triage error of the START triage system (2% to 53%) was slightly higher than the SALT triage system (2% to 22%). However, the time taken to apply START triage system (70 to 72.18 seconds) was faster than for the SALT triage system (78 seconds).
Conclusion: The START triage system was simpler and faster than SALT. Conversely, the SALT triage system appeared to be slightly more accurate, more consistent, and had a lower rate of under- and over-triage error than START. It appears that neither the SALT nor the START triage system is superior to the other. Further research is needed to establish the most appropriate disaster and MCI triage system, especially for the Indonesian context.


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Detail Information
Series Title
Nurse Media Journal of Nursing, Vol. 11 No. 3 December 2021
Call Number
(05) 610.5 DEP n
Publisher
Semarang : Department of Nursing, Faculty of Medicine Diponegoro University., 2021
Collation
Hlm. 413-427
Language
English
ISBN/ISSN
2087-7811
Classification
(05) 610.5 DEP n
Content Type
-
Media Type
-
Carrier Type
-
Edition
Vol. 11 No. 3 December 2021
Subject(s)
Effectiveness
disaster
mass casualty incidents
SALT triage system
START triage system
Specific Detail Info
-
Statement of Responsibility
-
Other version/related

No other version available

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  • The SALT and START Triage System for Classifying Patient Acuity Level: A Systematic Review
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