Sort-negative adult, grey teenager, bleeding first arrival — sieve numbers, paediatric splits, and what the index operation may contain

Examiner prompts

• The Sort says P2 with normal vitals. What does 15.7% sensitivity with 84.3% undertriage do to that label, and what is your next action?^[3]
• His shock index is 0.9. What does the 70.0%-versus-58.6% comparison buy you, and what is its boundary condition?^[16]
• The 6-year-old is grey and silent. Which tool, with what numbers, and why not the adult sieve or the tape?^[18][19]
• The belly bleeder arrives first, as expected. What exactly may the index operation contain, and what must it defer?^[12]
• The corridor now holds twenty more. How is the door organised, with what throughput precedent?^[14][26]

Model answers

• The Sort label reassures falsely: lowest accuracy of all tools at 15.7% sensitivity with 84.3% undertriage at 98.7% specificity — re-triage immediately, upgrade on mechanism and age, never discharge on a Sort P2.^[3]
• Shock index above 0.75 predicts LSI need at 70.0% sensitivity and 74.7% specificity against the Sort at 58.6% and 88.7% — it supports upgrading him, but civilian translation is unproven so physiology plus re-examination decides.^[16]
• Sieve her with the paediatric tool: SPTT 92.2% sensitive at 75.0% over-triage beats tape 34.1% and JumpSTART 45.0%; under-8 JumpSTART runs 86.3% and 84.8% while CareFlight predicts death best at 95.3% and 80.4% — accept the over-triage, resuscitate as P1.^[18][19]
• The index operation stops the bleeding and controls the contamination and nothing else — TASC serves the situation where damage control serves the patient; first arrivals bleed from trunk and cavities, so abbreviated laparotomy, pack, close, next patient.^[12]
• The door becomes a triage zone with streamed stations and 8-hourly rotations, after Mumbai's 163 triaged and 194 operations in 127 — because door accuracy is 61% with 18% of life-threats missed, re-triage every arrival.^[14][26]
• Doctrine close: triage early and dynamic by severity, necessity and urgency — and the BCD Sieve at 70.4% supersedes the NARU Sieve at 44.9% as the primary tool behind all of it.^[11][1]