Five-Level Triage: A Report from the ACEP/ENA Five-Level Triage Task Force

Fernandes, Christopher M.B.; Tanabe, Paula; Gilboy, Nicki; Johnson, L. J.; McNair, Rebecca S.; Rosenau, Alexander M.; Sawchuk, Peter; Thompson, David A.; Travers, Debbie; Bonalumi, Nancy; Suter, Robert E.

doi:10.1016/j.jen.2004.11.002

Cited by 226 publications

(213 citation statements)

References 36 publications

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“…4,[12][13][14][15][16][17][18] In a single-center study observing the transition from the CTAS to the Emergency Severity Index (ESI), the CTAS was shown to have a higher sensitivity for identifying abdominal pain requiring intensive care unit or operative management or ED death, with similar performance for patients presenting with chest pain. Previous studies reporting intrarater agreement found good agreement between triage nurses, but the number of participants in the intrarater arm of the study was quite low (n 5 12).…”

Section: Discussionmentioning

confidence: 99%

Reliability of the Canadian Triage and Acuity Scale: interrater and intrarater agreement from a community and an academic emergency department

Fernandes

McLeod

Krause

et al. 2013

CJEM

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Objectives: The Canadian Triage and Acuity Scale (CTAS) is a five-level triage tool that is used to help prioritize the order in which emergency department (ED) patients should be seen. The objectives of this study were to determine the interrater and intrarater agreement of the 2008 CTAS guideline revisions by triage nurses and to compare agreement between triage nurses working in a small community ED and an academic ED. Methods: Seventy-eight triage nurses assigned CTAS scores and free-text presenting complaints for 10 paper-based case scenarios. For five scenarios, the CTAS score should have remained unchanged from previous guidelines, whereas the other five scenarios should have been triaged differently based on the 2008 CTAS first-order modifiers. Thirty-three participants repeated the questionnaire 90 days later, and intrarater agreement was measured.

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Section: Discussionmentioning

confidence: 99%

Reliability of the Canadian Triage and Acuity Scale: interrater and intrarater agreement from a community and an academic emergency department

Fernandes

McLeod

Krause

et al. 2013

CJEM

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“…Additional data extracted from the ED documentation and tracking system included patient age, gender, triage ESI level (1)(2)(3)(4)(5), disposition (admitted, transferred, discharged, LWCE), and admission location (ICU, SDU, Ward).…”

Section: Methods and Measurementsmentioning

confidence: 99%

“…Over the years, a number of ED triage scales have been created, revised, implemented, and studied in attempts to ensure the accuracy of triage categorization. [1][2][3][4][5][6][7] Vital signs are often included in triage assessments and help guide triage classification and resultant timeliness of provider evaluation.…”

Section: Introductionmentioning

confidence: 99%

Can an emergency department clinical “triggers” program based on abnormal vital signs improve patient outcomes?

Imperato

Mehegan

Henning³

et al. 2016

CJEM

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Background: Because abnormal vital signs indicate the potential for clinical deterioration, it is logical to make emergency physicians immediately aware of those patients who present with abnormal vital signs. Objectives: To determine if a clinical triggers program in the emergency department (ED) setting that utilized predetermined abnormal vital signs to activate a rapid assessment by an emergency physician-led multidisciplinary team had a measurable effect on inpatient hospital metrics. Methods: The study design was a retrospective pre and post intervention study. The intervention was the implementation of an ED clinical "triggers" program. Abnormal vital sign criteria that warranted a trigger response included: heart rate <40 beats/minute or >130 beats/minutes, respiratory rate <8 breaths/minute or >30 breaths/minute, systolic blood pressure <90 mm Hg, or oxygen saturation <90% on room air. The primary outcome investigated was the median days admitted with secondary outcomes of median days in special care unit, in-hospital 30-day mortality and proportion of patients who required an upgrade in inpatient care level. Results: There was no difference in median days admitted for inpatient care (3.8 v. 4.0 days, p = 0.21) or median days spent in a special care unit (5.0 v. 5.6 days, p = 0.42) between the groups. There was no difference in the percentage of in-hospital patient deaths (6.0% v. 5.6%, p = 0.66) or frequency of upgrade in level of care within 24 hours (4.9% v. 4.0%, p = 0.52). Conclusions: In our study, the implementation of an ED clinical triggers program did not result in a significant change in measured inpatient outcomes.

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“…El criterio fundamental para la selección de los participantes en el estudio fue el de "problema de salud de baja complejidad". Para hacer operativo este criterio se utilizó el Sistema de Triaje del Hospital, que establece una escala de 5 niveles y unos tiempos de asistencia predefinidos, con el fin de que los pacientes sean atendidos según la gravedad que presenten a su llegada al SUH y no por el orden de llegada (Murray, Bullard, Grafstein, 2004;Fernandes, et al, 2005;Field, Lanz, 2006;Gómez, 2006;Puigblanque, Noheras, Hogueras, Perapoch, 2008) (ver Tabla 1). Se entendió entonces por pacientes con problemas de salud de baja complejidad aquellos que quedaron ubicados en los niveles IV y V de la Escala de Triaje realizado por el personal de enfermería al momento de ingresar al Servicio de Urgencias.…”

Section: Diseño Del Estudiounclassified

Utilización por cuenta propia de los Servicios de Urgencias Hospitalarias: razones que dan las personas con problemas de salud de baja complejidad para utilizar estos servicios

et al. 2011

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RESUMENObjetivos: Los objetivos de este estudio son: 1) Comprender las razones y los motivos que impulsan a las personas con problemas de salud de baja complejidad (PSBC) para acudir, por cuenta propia y sin ser remitidos por su médico de cabecera (MC), al servicio de urgencias de un hospital general (SUH). 2) Conocer la percepción sobre el grado de gravedad y preocupación atribuidos por las personas a su problema de salud. 3) Determinar los factores que influyen en la decisión de acudir por cuenta propia al SUH. Metodología. Diseño: Estudio transversal a través de entrevista personal con cuestionario estructurado, mediante muestreo no probabilístico por cuotas. Contexto: SUH del Hospital Infanta Cristina de Parla, Madrid, España. Participantes: Se entrevistaron a pacientes seleccionados por los niveles IV y V de la Escala Española de Triaje, que acudieron por cuenta propia al SUH, de lunes a domingo, entre las 10:00

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Five-Level Triage: A Report from the ACEP/ENA Five-Level Triage Task Force

Cited by 226 publications

References 36 publications

Reliability of the Canadian Triage and Acuity Scale: interrater and intrarater agreement from a community and an academic emergency department

Reliability of the Canadian Triage and Acuity Scale: interrater and intrarater agreement from a community and an academic emergency department

Can an emergency department clinical “triggers” program based on abnormal vital signs improve patient outcomes?

Utilización por cuenta propia de los Servicios de Urgencias Hospitalarias: razones que dan las personas con problemas de salud de baja complejidad para utilizar estos servicios

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