Correct triage at the scene increases success in the ED: Sabiha Gökçen Airport plane accident

BACKGROUND: Triage is the most important part of the management of events, such as accidents, earthquakes, fires, and floods, in which mass injuries occur. The aim of this study is to evaluate the effects of triage on patient outcomes, injuries, the role of trauma mechanisms, and spinal immobilization during transportation following the plane crash at the İstanbul Sabiha Gökçen airport that involved 183 patients on February 5, 2020. METHODS: Command control center data and ambulance and medical charts were examined retrospectively. The results were evaluated in terms of spinal immobilization, injury type, triage codes, and ISS values during emergency interventions and transportation. RESULTS: We received the first notice at 18:21 about the plane that had landed and crashed at 18:19 on February 5, 2020, and the first team reached the security gate at 18:26. The first team arrived at the debris field and performed triage. On the airside of the airport, the first victims were taken at 18:32, transferred at 18:36, and reached the hospital at 18:41. The first case was taken from the debris field at 18:35 and transferred to the hospital. Of the 183 patients on the plane, three became exitus at the scene, 43.7% of the victims were female, and the mean age was 35.0±15.7. The mean systolic blood pressure of the victims was 122.0±17.4. The mean distance to hospitals, transportation time, intervention time, heart rate, and ISS levels were measured as 55.0 (23.0–79.0) km; 780.5 (390.0–1540.0) s; 817.0 (552.0–1200.0) s; 86.0 (78.0–100.0); and 4.5 (1.0–9.0), respectively. A positive significant correlation was found between ISS and the days of hospitalization (r=0.577; p<0.001). CONCLUSION: The fact that no patient was lost during the follow-up and treatment is an indication that triage, appropriate patient referral to the appropriate hospital, and primary and secondary care are well performed, as well as the crash of the plane while landing. Coordinated acts of the airport and 112 emergency health services and guidance for appropriate triage reduced both pre-hospital and hospital mortality.