An Evaluation of a Modified CTAS at an Accident and Emergency Department in a Developing Country

Abstract

Objectives To review the modified Canadian Triage and Acuity Scale used in an accident and emergency department in Trinidad and Tobago. Design and Methods A cross-sectional study was carried out. Times from assignment of triage category to being seen by a physician were collected from the patient notes on the days of presentation and compared to the reference standards. Times from decision to admit to obtaining a bed were also recorded. Results 200 patients were included in the study. The median waiting time for patients in the immediate/blue category was 3 minutes (range = 3); for the red category, it was 31.2 minutes (range = 121.8); in the yellow category, it was 61.8 minutes (range = 805.2). The overall admission rate was 30.5%, with an admission rate of 25% for the blue category; 20% of patients in the red category waited more than 4 hours for a hospital bed. Conclusion The patients assigned to the blue category were being seen almost immediately. Less critical persons wait longer than the reference times and this may be due to structural factors such as staffing. The admission rates per category highlighted a low admission rate for the blue category (25%), which is unusual. This study highlights the need for a further study to review clinical presentation, assignment to triage category, and outcomes.

Emergency Department Nurses’ Knowledge Regarding Triage

“…The CTAS aims to use a complaint list and specific physiological modifiers to sort patients into triage levels based on an ideal maximum amount of time within which a patient should see a physician (Pooransingh et al, 2018).It contains of five levels/ categories from immediate that need resuscitation up to non-urgent that need primary care (Aljohani, 2011).…”

<p>Utilization of an Electronic Triage System by Emergency Department Nurses</p>

“…2 Numerous triage instruments are in use around the world, including the Canadian Triage and Acuity Scale (CTAS), the Manchester Triage System, the Australasian Triage Scale, and the Emergency Severity Index. 3 The CTAS is one of the most popular triage systems in the world. It uses five levels to prioritize patients in an emergency department, organize the flow of patients in the hospital, and distribute the workload.…”

Consistency of triage scores by presenting complaint pre‐ and post‐implementation of a real‐time electronic triage decision support tool

“…The Canadian Triage and Acuity Scale (CTAS) is the standard used in all Canadian and many international EDs to aid in safely determining the priority by which patients should be assessed. [1][2][3][4][5][6][7] The scale delineates 5 levels of acuity: level 1 (resuscitation), level 2 (emergent), level 3 (urgent), level 4 (less urgent), and level 5 (non-urgent). [8][9][10][11] CTAS is similar to other triage algorithms including the Australasian Triage Scale 12 and the Manchester Triage Scale (MTS) 13 , which categorize patients based on perceived clinical urgency, but differs from other triage scales such as the Emergency Severity Index, 14 which also incorporates the anticipated number of resources that may be required.…”

“…Triage is a fundamental process for the safe and efficient management of patients where health care demands exceed available emergency department (ED) resources. The Canadian Triage and Acuity Scale (CTAS) is the standard used in all Canadian and many international EDs to aid in safely determining the priority by which patients should be assessed 1‐7 . The scale delineates 5 levels of acuity: level 1 (resuscitation), level 2 (emergent), level 3 (urgent), level 4 (less urgent), and level 5 (non‐urgent) 8‐11 .…”