Triage: what can we do to improve our practice?

Guidet, Bertrand; Hejblum, Gilles; Joynt, Gavin M.

doi:10.1007/s00134-013-3063-0

Cited by 7 publications

(3 citation statements)

References 12 publications

(4 reference statements)

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“…Despite some previous attempts, no single objective, evidence-based triage tool in the form of a score or combination of scores has been shown to effectively determine appropriate ICU admission priority. [13][14][15] Development of a guidance tool was thus initiated using an iterative process in which possible combinations of predictive scoring components were progressively evaluated for face validity by experienced intensive care specialists. The local development of this triage tool to accompany the Admission, Discharge, and Triage Guidelines for Hong Kong (outlined above) was led by 10 senior ICU clinical specialists who are currently practising in ICUs in Hong Kong.…”

Section: Methodsmentioning

confidence: 99%

Admission triage tool for adult intensive care unit admission in Hong Kong during the COVID-19 outbreak

Joynt

Leung

et al. 2021

Hong Kong Med J

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Intensive care is expensive, and the numbers of intensive care unit (ICU) beds and trained specialist medical staff able to provide services in Hong Kong are limited. The most recent increase in coronavirus disease 2019 (COVID-19) infections over July to August 2020 resulted in more than 100 new cases per day for a prolonged period. The increased numbers of critically ill patients requiring ICU admission posed a capacity challenge to ICUs across the territory, and it may be reasonably anticipated that should a substantially larger outbreak occur, ICU services will be overwhelmed. Therefore, a transparent and fair prioritisation process for decisions regarding patient ICU admission is urgently required. This triage tool is built on the foundation of the existing guidelines and framework for admission, discharge, and triage that inform routine clinical practice in Hospital Authority ICUs, with the aim of achieving the greatest benefit for the greatest number of patients from the available ICU resources. This COVID-19 Crisis Triage Tool is expected to provide structured guidance to frontline doctors on how to make triage decisions should ICU resources become overwhelmed by patients requiring ICU care, particularly during the current COVID-19 pandemic. The triage tool takes the form of a detailed decision aid algorithm based on a combination of established prognostic scores, and it should increase objectivity and transparency in triage decision making and enhance decisionmaking consistency between doctors within and

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Section: Methodsmentioning

confidence: 99%

Admission triage tool for adult intensive care unit admission in Hong Kong during the COVID-19 outbreak

Joynt

Leung

et al. 2021

Hong Kong Med J

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“…Many factors, including differences in socioeconomic status, cultural attitudes, and resource availability among countries, may influence this process (2)(3)(4). Therefore, to provide general guidance for intensivists in making ICU triage decisions, the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) assigned a multidisciplinary task force to address four basic questions regarding this process.…”

mentioning

confidence: 99%

Triage decisions for ICU admission: Report from the Task Force of the World Federation of Societies of Intensive and Critical Care Medicine

Blanch

Abillama

Amin

et al. 2016

Journal of Critical Care

102

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“…Triage is the process of patient categorization and prioritization based on medical needs and allocation of resources to patients who have a chance to benefit from these resources [4,7]. Recent evidence suggests that the process of triage is often unofficial or decisions are taken in an ad hoc fashion, and its practical aspects are implemented in different ways [8][9][10]. Hence, those who perform triage in disasters face a tough decision as to who should receive limited life-saving treatments or who may not benefit from such care [11,12].…”

mentioning

confidence: 99%

Ethical Patient Prioritization in Disaster Triage: A Protocol for a Systematic Review

Ghanbari

Zareiyan

Nejati

et al. 2019

HDQ

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Background: Disasters are medically defined as events in which the demands for patients' care far exceed the available resources. In such situations, triage and rationing of limited resources are inevitable. A decision regarding triage needs not only scientific guidelines but also an ethical framework and supporting policies. This study aims to provide a comprehensive review of the criteria for ethical decision-making in disasters triage. Materials and Methods: Medline (Via pubMed.com), Scopus, Web of Science, and ProQuest databases will be searched from 1990 to July 2017 using a defined search strategy. Other search resources include Google Scholar, World Health Library, Global Ethics Library, Gray Literature Report website, and World Health Organization (WHO), which will be searched using a modified search strategy. The manual search will be conducted in two journals with the highest number of retrieved titles in the Scopus search and the reference list of selected articles. Study selection, quality assessment, and data extraction will be done by the first author, and the second reviewer will check the results, and probable disagreements will be resolved through discussion and review by a third reviewer. Results: This systematic review will identify all factors a triage officer should be considered when he or she would like to make an ethical decision. Conclusion: Transparency and consistency are two main procedural ethical values of disaster triage. The result of this review could be used to make a consistent decision in disaster triage.

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Triage: what can we do to improve our practice?

Cited by 7 publications

References 12 publications

Admission triage tool for adult intensive care unit admission in Hong Kong during the COVID-19 outbreak

Admission triage tool for adult intensive care unit admission in Hong Kong during the COVID-19 outbreak

Triage decisions for ICU admission: Report from the Task Force of the World Federation of Societies of Intensive and Critical Care Medicine

Ethical Patient Prioritization in Disaster Triage: A Protocol for a Systematic Review

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