Introduction: Effective triage at mass gatherings is essential for optimal resource allocation and timely medical care. Unlike disaster or hospital settings, mass gatherings present unique challenges. The primary objectives of triage at such events are to identify and prioritize life-threatening conditions, recognize cases exceeding available care levels, and minimize disruptions for both patients and the event itself. This study introduces a novel decision-support tool for triaging patients at mass gatherings, directing them to either a “Medical Zone” or a “First Aid Zone” based on non-vital sign criteria. The tool employs four straightforward questions to facilitate rapid triage. The inter-rater consistency was assessed to determine the tool’s reliability. Methods: Thirty-one responders with experience in event-based care assessed 46 written patient vignettes, assigning each patient to either the Medical Zone or First Aid Zone based on four binary questions: 1) Is the patient unable to walk calmly and independently? 2) Is the patient communicating in a distressed manner? 3) Does the patient have cardiac or respiratory complaints? 4) Does the patient give a worrying impression? Responders included event first responders, emergency medical technicians, nurses, and physicians, all of whom received standardized instructions on the tool’s usage. Results: The overall inter-rater agreement for triage decisions, measured by Fleiss’ Kappa (0.64, P < 0.001), demonstrated substantial consistency among responders. This suggests that the tool can consistently guide responders in assigning patients to the appropriate care zones, thereby supporting efficient resource allocation in the field. Conclusion: This four-question triage tool demonstrates substantial inter-rater reliability, showing promise as a reliable and efficient method for triaging patients at mass gatherings. Future studies should evaluate its effectiveness in live field conditions to validate its practical impact on the triage process during large-scale events.
Scholliers et al. (Sun,) studied this question.