Risk classification priorities in an emergency unit and outcomes of the service provided

Abstract

Objective:to check the association of the proposed priorities of the institutional protocol of risk classification with the outcomes and evaluate the profile of the care provided in an emergency unit. Method:observational epidemiological study based on data from the computerized files of a Reference Emergency Unit. Care provided to adults was evaluated regarding risk classification and outcomes (death, hospitalization and hospital discharge) based on the information recorded in the emergency bulletin. Results:the mean age of the 97,099 registered patients was 43.4 years; 81.5% cases were spontaneous demand; 41.2% had been classified as green, 15.3% yellow, 3.7% blue, 3% red and 36.and 9% had not received a classification; 90.2% of the patients had been discharged, 9.4% hospitalized and 0.4% had died. Among patients who were discharged, 14.7% had been classified as yellow or red, 13.6% green or blue, and 1.8% as blue or green. Conclusion:the protocol of risk classification showed good sensitivity to predict serious situations that can progress to death or hospitalization.

Performance of the rapid triage conducted by nurses at the emergency entrance

“…The mortality rate in the sample was substantially higher than those found in the literature ( 8 , 14 ) . However, it is worth noting that the sample was composed only of patients who reported severity when they arrived at the emergency service and, therefore, were potentially more serious than the general population seeking ED, frequently investigated in other studies.…”

“…As for the death outcome, the two systems showed similar values in most of the analyses performed. Researchers who investigated the triage given by an institutional protocol with the outcomes of patients seen at an emergency unit in the inland of São Paulo identified that, among the patients considered severe, the death rate corresponded to 66.7% and, in the group of low priority of care, this rate was 1.7% ( 14 ) . There was also a group of patients who were not classified by the institutional protocol due to situations of extreme severity and, therefore, were referred directly to the emergency room, where they had a death rate of 31.4% ( 14 ) .…”

“…Researchers who investigated the triage given by an institutional protocol with the outcomes of patients seen at an emergency unit in the inland of São Paulo identified that, among the patients considered severe, the death rate corresponded to 66.7% and, in the group of low priority of care, this rate was 1.7% ( 14 ) . There was also a group of patients who were not classified by the institutional protocol due to situations of extreme severity and, therefore, were referred directly to the emergency room, where they had a death rate of 31.4% ( 14 ) . Another study identified that patients classified as high priority for care by the MTS have a 5.58 times greater chance of progressing to death than those classified as low priority ( 8 ) .…”

Manchester Triage System: assessment in an emergency hospital service

“…Patients in the red category had a higher percentage of deaths. Research that correlated RS categories with the outcomes of care also found a higher occurrence of deaths in high-priority patients (7,18,37) . Another study (17) also found that MTS is a good predictor of death, i.e., the greater the severity of patients, the greater the chance of dying.…”

Perfil epidemiológico dos atendimentos de um pronto atendimento privado do sul do Brasil

“…Segundo os autores, a utilização dos serviços de emergências pela população não reflete emergências. Entende-se que elas estejam ligadas à compreensão de utilização desses serviços, como uma porta qualificada de acesso ao sistema de saúde, desconsiderando a ABS, nicho destinado a absorver a demanda de baixa complexidade 28. ConclusãoOs resultados indicam diferenças geracionais e de gênero na utilização do serviço e evidencia o comportamento sazonal de utilização entre os dias da semana.…”