Turkiye Klinikleri Journal of Medical Ethics-Law and History

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Afetlerde Triyajın Etik Bağlamda İncelenmesi: Sistematik Derleme
Examination of Triage in Disasters in the Ethical Context: Systematic Review
Esra BEKİRCANa , Abdülkadir GÜNDÜZb
aTrabzon Üniversitesi Tonya Meslek Yüksekokulu, Tıbbi Hizmetler ve Teknikler Bölümü, İlk ve Acil Yardım Programı, Trabzon, Türkiye
bKaradeniz Teknik Üniversitesi Tıp Fakültesi, Acil Tıp AD, Trabzon, Türkiye
Turkiye Klinikleri J Med Ethics. 2025;33(3):155-63
doi: 10.5336/mdethic.2024-108040
Article Language: TR
Full Text
ÖZET
 Bu çalışmanın amacı, afetlerde triyaj uygulamasına ilişkin etik kavramı üzerine yapılmış çalışmaları derlemek ve bu çalışmaların genel özelliklerini betimsel özetler yolu ile listelemektir. Sistematik derleme metodolojisinin kullanıldığı bu araştırma; PubMed, Web of Science, Google Akademik ve Dergipark veri tabanlarında yıl sınırlamasına gidilmeden tam metin hâline ulaşılabilen nicel ve nitel araştırma makaleleri taranarak gerçekleştirilmiştir. Literatür taraması ''afet'', ''triyaj'', ''etik'', ''afetlerde triyaj'', ''afetlerde triyaj etiği'' anahtar kelimelerinin çeşitli kombinasyonları ile gerçekleştirilmiştir. Veri tabanı taraması sonucunda elde edilen çalışmalar (n=34.301), öncelikle başlıklarına ve özetlerine göre incelenmiştir. Başlık ve özet incelemesinden sonra kalan çalışma sayısı 110 olup, ardından tam metin incelemesi yapılmıştır. Tam metin incelemesinin ve tekrar eden çalışmaların çıkarılmasının ardından sistematik derlemeye 8 çalışma dâhil edilmiştir. Araştırmada kullanılan veri çekme aracı (kod cetveli), araştırmacılar tarafından oluşturulmuştur. Sistematik derlemede yer alan çalışmaların incelenmesi sonucunda afetlere müdahalede triyaj uygulamalarında kıt kaynakların kullanımı, resüsitasyon kararı, afetzedelerin nakilleri, hastane koordinasyonu sağlamada etik ikilemler yaşandığı belirlenmiştir. Afetlerde, triyaj uygulamasının etik ve adil bir şekilde yapılabilmesi için afet öncesinde duygu yönetimi, triyaj ve ezilme sendromu gibi özel beceriler için eğitim verilmesinin gerekliliği vurgulanmıştır. Afetlerde ilk ve tekrar triyajda etik sorunların yaşandığı belirtilmiştir. Bu sistematik derleme araştırmasıyla afetlerde triyaj uygulamasına ilişkin kısıtlı sayıda çalışmaların bulunduğu ve mevcut bulguların derinlemesine ele alınabilmesi için daha fazla araştırmaya ihtiyaç olduğu sonucuna ulaşılmıştır.

Anahtar Kelimeler: Afet; triyaj; etik; afet triyaj etiği; sistematik derleme
ABSTRACT
 The aim of this study is to compile studies conducted on the ethical concept related to triage practices in disasters and to list the general characteristics of these studies through descriptive summaries. This research was conducted using a systematic review methodology by screening quantitative and qualitative research articles accessible in full text from the PubMed, Web of Science, Google Scholar, and Dergipark databases, without applying any publication year limitations. The literature search was performed using various combinations of the keywords ''disaster'', ''triage'', ''ethics'', ''disaster triage'', and ''disaster triage ethics''. As a result of the database search, a total of 34,301 studies were initially identified and screened based on their titles and abstracts. Following this screening, 110 studies were selected for full-text review. After evaluating the full texts and removing duplicate studies, 8 studies were included in the systematic review. The data extraction tool (coding framework) used in the study was developed by the researchers. Examination of the studies included in the systematic review revealed that ethical dilemmas arise in disaster triage practices in areas such as the use of scarce resources, resuscitation decisions, transfer of disaster victims, and coordination among hospitals. It was emphasized that in order for triage practices in disasters to be carried out ethically and fairly, pre-disaster training on emotional management and specific skills such as triage and crush syndrome is necessary. It was also reported that ethical problems are encountered in both initial and repeated triage processes during disasters. This systematic review concluded that there are a limited number of studies on triage practices in disasters and that more in-depth research is needed to elaborate on the existing findings.

Keywords: Disaster; triage; ethics; disaster triage ethics; systematic review
REFERENCES:
  1. Mohamed Shaluf I. Disaster types. Disaster Prevention and Management: An International Journal. 2007;16(5):704-17. [Crossref] 
  2. Kouadio IK, Aljunid S, Kamigaki T, Hammad K, Oshitani H. Infectious diseases following natural disasters: prevention and control measures. Expert Rev Anti Infect Ther. 2012;10(1):95-104. [Crossref]  [PubMed] 
  3. Kalanlar B, Akkaya G. Nursing student's experiences of Role-Play Scenario-Based Disaster Triage (START) training: a qualitative research. Nurse Educ Today. 2024;141:106307. [PubMed] 
  4. Bazyar J, Farrokhi M, Salari A, Khankeh HR. The principles of triage in emergencies and disasters: a systematic review. Prehosp Disaster Med. 2020;35(3):305-13. [PubMed] 
  5. Usta G, Torpuş K, Küçük U. Afetlerde START triaj skalası [START triage scale in disasters]. Doğal Afetler ve Çevre Dergisi. 2017;3(2):70-6. [Link] 
  6. Franc JM, Kirkland SW, Wisnesky UD, Campbell S, Rowe BH. METASTART: a systematic review and meta-analysis of the diagnostic accuracy of the simple triage and rapid treatment (START) algorithm for disaster triage. Prehosp Disaster Med. 2022;37(1):106-16. MID: 34915954. [Crossref] 
  7. Curran-Sills G, Franc JM. A pilot study examining the speed and accuracy of triage for simulated disaster patients in an emergency department setting: comparison of a computerized version of Canadian Triage Acuity Scale (CTAS) and Simple Triage and Rapid Treatment (START) methods. CJEM. 2017;19(5):364-71. [Crossref]  [PubMed] 
  8. Picard CT, Kleib M, O'Rourke HM, Norris CM, Douma MJ. Emergency nurses' triage narrative data, their uses and structure: a scoping review protocol. BMJ Open. 2022;12(4):e055132. [Crossref]  [PubMed]  [PMC] 
  9. Christian MD. Triage. Crit Care Clin. 2019;35(4):575-89. [PubMed]  [PMC] 
  10. Janousek JT, Jackson DE, De Lorenzo RA, Coppola M. Mass Casualty triage knowledge of military medical personnel. Military Medicine. 1999;164(5):332-5. [Crossref] 
  11. Robertson-Steel I. Evolution of triage systems. Emerg Med J. 2006;23(2):154-5. [Crossref]  [PubMed]  [PMC] 
  12. Jenkins JL, McCarthy ML, Sauer LM, Green GB, Stuart S, Thomas TL, et al. Mass-casualty triage: time for an evidence-based approach. Prehosp Disaster Med. 2008;23(1):3-8. [PubMed] 
  13. Lerner EB, Schwartz RB, Coule PL, Weinstein ES, Cone DC, Hunt RC, et al. Mass casualty triage: an evaluation of the data and development of a proposed national guideline. Disaster Med Public Health Prep. 2008;2 Suppl 1:S25-34. [Crossref]  [PubMed] 
  14. Geale SK. The ethics of disaster management, Disaster Prevention and Management. 2012;21(4):445-62. [Crossref] 
  15. Şen G. Sağlık profesyonellerinin afet triyajında etik karar verebilme durumları: İzmir ili örneği [Healthcare professionals? levels of disaster triage and ethical decision making: İzmir province samples]. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2018;9(1):57-66. [Crossref] 
  16. Wagner JM, Dahnke MD. Nursing ethics and disaster triage: applying utilitarian ethical theory. J Emerg Nurs. 2015;41(4):300-6. [PubMed] 
  17. Orfali K. What triage issues reveal: ethics in the covıd-19 pandemic in Italy and France. Journal Of Bioethical Inquiry. 2020;17:675-9. [Crossref]  [PubMed]  [PMC] 
  18. Ghanbari V, Ardalan A, Zareiyan A, Nejati A, Hanfling D, Bagheri A, et al. Fair prioritization of casualties in disaster triage: a qualitative study. BMC Emerg Med. 2021;21(1):119. [PubMed]  [PMC] 
  19. Ekşi A, Şen G, Çelikli, S. Afet triyajında etik ikilemlerin değerlendirilmesi-İzmir ili örneği [Evaluation of ethical dilemmas in disaster triage example of İzmir]. Türkiye klinikleri tıp Etiği, Hukuku ve Tarihi Dergisi. 2019;27(1):30-9. [Crossref] 
  20. Yalçın G, Özdemir Balcı Ö, Başer A, Aydın Güler Y, Anıl M. Çocuk acil servis sağlık çalışanlarının pediatrik afet triyajı bilgi düzeyleri [Pediatric disaster triage knowledge levels of pediatric emergency department health care workers]. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2024;15(2):252-61. [Crossref] 
  21. Gökkaya E, Dinç A. UMKE çalışanlarının afet durumunda etik yaklaşımlarının incelenmesi; Güney Marmara örneği [The research on the ethical attitudes of UMKE staff during disaster: example of South Marmara]. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2020;9(1):17-24. [Crossref] 
  22. Nekooei Moghaddam M, Saeed S, Khanjani N, Arab M. Nurses' requirements for relief and casualty support in disasters: a qualitative study. Nurs Midwifery Stud. 2014;3(1):e9939. [PubMed]  [PMC] 
  23. Civaner MM, Vatansever K, Pala K. Ethical problems in an era where disasters have become a part of daily life: a qualitative study of healthcare workers in Turkey. PLoS One. 2017;12(3):e0174162. [PubMed]  [PMC] 
  24. Kiani M, Fadavi M, Khankeh H, Borhani F. Personal factors affecting ethical performance in healthcare workers during disasters and mass casualty incidents in Iran: a qualitative study. Med Health Care Philos. 2017;20(3):343-51. [Crossref]  [PubMed] 
  25. Utlu N. Hastane ortamında hemşirelerin etik yaklaşımı ve etik ikilemler. İstanbul Aydın Üniversitesi Dergisi. 2016;8(29):17-35. [Crossref] 
  26. Karahan Okuroğlu K, Bahçecik N, Ecevit Alpar Ş. Felsefe ve hemşirelik etiği [Philosophy and nursing ethics]. Kilikya Felsefe Dergisi. 2014;(1):53-61. [Link] 
  27. Kuschner WG, Pollard JB, Ezeji-Okoye SC. Ethical triage and scarce resource allocation during public health emergencies: tenets and procedures. Hosp Top. 2007;85(3):16-25. [Crossref]  [PubMed] 
  28. Mills AF, Argon NT, Ziya S. Resource-based patient prioritization in mass-casualty incidents. Manufacturing&Service Operations Management. 2013;15(3):361-77. [Crossref]  [PubMed] 
  29. Good L. Ethical decision making in disaster triage. J Emerg Nurs. 2008;34(2):112-5. [Crossref]  [PubMed] 
  30. Abu-Zidan FM, Idris K, Cevik AA. Prehospital management of earthquake crush injuries: a collective review. Turk J Emerg Med. 2023;23(4):199-210. [PubMed]  [PMC] 
  31. Topal S, Özhanlı Y, Çaka SY, Gürbüz Y. Professional competences of emergency department nurses working in the earthquake region on triage management in children and the difficulties experienced by nurses in the decision-making process: a qualitative study. International Journal of Disaster Risk Reduction. 2024;113:104844. [Crossref] 
  32. Sevimli S, Dursun R, Karadas S. Health professionals of emergency service: evaluation of triage and ethical values in disaster medicine. Journal of Academic Emergency Medicine. 2015;14(3):107-12. [Crossref]  [PubMed] 
  33. Mallia P. Towards an ethical theory in disaster situations. Med Health Care Philos. 2015;18(1):3-11. [Crossref]  [PubMed] 
  34. Pandit K, Healy E, Todman R, Kingon A, Wright M, Raymond M, et al. Disaster triage skills training: an introductory virtual simulation for medical students. Cureus. 2023;15(5):e39417. [PubMed]  [PMC] 
  35. Gautschi OP, Cadosch D, Rajan G, Zellweger R. Earthquakes and trauma: review of triage and injury-specific, immediate care. Prehosp Disaster Med. 2008;23(2):195-201. [Crossref]  [PubMed] 
  36. Stewart D, Naeglw MA, Rolland EG, Hughes F, Ryan K. Ruh Sağlığı ve Psikiyatri Hemşireliği Uygulamaları Kılavuzu. Hiçdurmaz D, Dikeç G, çeviri editörleri. International Council of Nurses. 2024. [Link] 

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