In mass casualty incidents, patients with apparent hemodynamic and respiratory stability might have occult life-threatening injuries. These patients could benefit from more accurate evaluations to be sorted into triage categories for the purpose of treatment and priority transport decisions.

This study assessed the impact of point-of-care ultrasound (POCUS) on the accuracy of secondary triage conducted at an advanced medical post (AMP) to enhance the detection of patients who, despite their apparent clinically stable condition, had simulated occult life-threatening injuries.

To determine if a WHO EMT could potentially benefit from the utilization of POCUS to guide lifesaving interventions and priority transport decisions.

A mass casualty simulated incident consisting of a bomb blast in a remote area was conducted with 10 simulated casualties classified as YELLOW, delayed transport per Simple Triage and Rapid Treatment (START), at the primary triage scene.

Patients were evaluated by 4 physicians at an AMP. Three patients had, respectively, hemoperitoneum, pneumothorax, and hemothorax. All physicians were competent in the use of POCUS to assess trauma patients. Two of the four physicians were provided the use of POCUS.

All 4 physicians were able to suspect hemoperitoneum, but only physicians utilizing POCUS detected pneumothorax and hemothorax.

This study suggests that POCUS-enhanced secondary MCI triage at an AMP may represent an effective methodology to accurately detect non-apparent injuries that require life-saving interventions or priority transport. Further studies with larger samples conducted in varied MCI scenarios are warranted to provide the support for the WHO EMT to adopt POCUS as triage tool.