Royal Navy Doctor Changing The Way Medics Respond To Major Incidents

The work of a Royal Navy doctor is being implemented by the NHS and the Defence Medical Services for use in the aftermath of terrorist attacks and mass casualty incidents.  

Advances in military medicine have often filtered into civilian care, such as blood transfusions in the First World War to the treatment used on casualties in Afghanistan.

Deciding the priority of treatment in mass casualty incidents is known as 'triage' and is vital not only in military situations but is also pivotal in the wake of terrorist attacks in the UK.  Key to success in triage is identifying patients who need life-saving interventions.

For years medics have been using flow charts to conduct triage and to determine the priority of treatment for patients in mass casualty incidents.

But recent studies show that the existing method of UK triage (both military and civilian) has only between 28-43% chance of correctly prioritising patients in need of life-saving interventions.

Royal Navy Emergency Medicine Trainee, Surgeon Lieutenant Commander Jamie Vassallo, has been studying triage since 2010 and undertook a PhD to try and optimise the process.

His new model, the Modified Physiological Triage Tool-24 (MPTT-24) allows for a quicker assessment at the scene and in the military setting can correctly identify over 80% of patients in need of urgent intervention.

Surgeon Lieutenant Commander Vassallo said: "What we’re seeing from recent major incidents is that quite often the initial triage process is being conducted by non-medical personnel such as police firearms officers.

"What we need therefore is an effective triage process that can be utilised irrespective of the background of the provider. 

"The benefit of the MPTT-24 is that it was designed in such a way that it can be reliably used by a variety of individuals, irrespective of their clinical experience.” 

The MPTT-24 has been incorporated into the new 2018 NHS England Clinical Guidelines for Major Incidents and additionally is being introduced as the new method of triage within the Defence Medical Services where it has already demonstrated very good success rates on recent exercises.

He added: "It's been a number of years of hard work - which was the basis of doing the PhD in Major Incident triage.

"It's not often that you see outputs from PhDs being implemented into practice - certainly not as soon as this has been done, so it really is a proud moment of mine."

The nature of the MPTT-24 means that it is transferable to be able to be reliably used by first responders, firearms officers, and non-medical service personnel.