“…18 One study indicated moderate agreement in ESI level designation by paramedics and nurses (0.409; 95% confidence interval [CI], 0.256-0.562). 19 Limitations to ESI use include the lack of a common language; differences in training between paramedics and nurses; differences in purpose and understanding of triage regarding the chronically ill/ injured; and the need to limit under-triage. 20 In contrast to the structure of the ESI, the CTAS uses an extensive list of clinical complaints, symptoms, and modifiers, at strategic times, to direct users toward a specific classification.…”