RATE - Disaster triage

23 March 2022
Gudrun Reay and Cathy Dobson on the RATE protocol...
Reay G, Rankin JA, Dobson C, Campbell K. Mass casualty triage for the Emergency Department using the RATE protocol: Validation and results of a quasi-experiment. International emergency nursing. 2022 Mar 1;61:101124.

HIGHLIGHTS
• A group of five triage experts validated the RATE protocol.
• Two RATE training methods were tested in a quasi-experiment with triage RNs.
• A RATE infographic or an e-learning module can be used for staff training.
• The RATE infographic is convenient for resource poor areas or just-in-time training.

BACKGROUND
Triage practices in the Emergency Department (ED) need to be modified during a mass casualty incident (MCI) to accommodate the influx of patients. A triage protocol known as Rapid Assessment Triage for Emergency Department/Urgent Care (RATE) was developed specifically for use in EDs during MCIs.

METHODS
Phase 1: validation of the RATE protocol by triage experts. Phase 2: a pretest/ post-test quasi-experiment comparing a RATE infographic with a RATE e-learning module in a convenience sample of 64 triage Registered Nurses from two EDs.

RESULTS
Phase 1: the five experts reached 100% consensus for 20 patient vignettes. Phase 2: there were no statistically significant differences on pre-test and post-test scores within and between RN groups controlling for age, years as an RN, years as an ED RN, and years as a triage RN (all p values > 0.05). There was no group by time interaction (p = 0.49).

CONCLUSION
The RATE protocol was validated. As there were no statistically significant differences between the groups using the RATE infographic or the elearning module, either method can be used for training purposes. The infographic is cost effective and may be preferred in resource poor environments or when just-in-time training is required.

Keywords: Triage, Mass casualty incident, Emergency department, Infographic, Computer-assisted instruction, Online education, Disasters, Learning methods