ABSTRACT
BACKGROUND@#It is not clear whether Emergency Severity Index (ESI) is valid to triage heart failure (HF) patients and if HF patients benefit more from a customized triage scale or not. The aim of study is to compare the effect of Heart Failure Triage Scale (HFTS) and ESI on mistriage among patients with HF who present to the emergency department (ED).@*METHODS@#A randomized clinical trial was conducted from April to June 2017. HF patients with dyspnea were randomly assigned to HFTS or ESI groups. Triage level, used resources and time to electrocardiogram (ECG) were compared between both groups among HF patients who were admitted to coronary care unit (CCU), cardiac unit (CU) and discharged patients from the ED. Content validity was examined using Kappa designating agreement on relevance (K*). Reliability of both scale was evaluated using inter-observer agreement (Kappa).@*RESULTS@# Seventy-three and 74 HF patients were assigned to HFTS and ESI groups respectively. Time to ECG in HFTS group was significantly shorter than that of ESI group (2.05 vs. 16.82 minutes). Triage level between HFTS and ESI groups was significantly different among patients admitted to CCU (1.0 vs. 2.8), cardiac unit (2.26 vs. 3.06) and discharged patients from the ED (3.53 vs. 2.86). Used resources in HFTS group was significantly different among triage levels (H=25.89; df=3; P<0.001).@*CONCLUSION@# HFTS is associated with less mistriage than ESI for triaging HF patients. It is recommended to make use of HFTS to triage HF patients in the ED.
ABSTRACT
PURPOSE: Triage is the initial clinical evaluation process in a hospital emergency department (ED). The Korean Triage and Acuity Scale-based triage system (KTAS) has been developed and used in Korean EDs as a triage tool. However, there has been limited evidence of its reliability and validation in KTAS. The aim of this study was to validate KTAS by comparing the Emergency Severity Index (ESI). METHODS: This was a prospective study. All adult patients over the age of 18 years who visited our ED during the study period were included. Patients were independently triaged by a primary triage nurse using KTAS and emergency physician by ESI. The total admission rate (TAR) and length of stay (LOS) were analyzed by comparing KTAS and ESI according to acuity levels. RESULTS: A total of 2919 patients were enrolled in our study. With KTAS, 0.8%, 9.3%, 41.6%, 39.7%, and 8.6% were assigned to the levels 1, 2, 3, 4, and 5, respectively. With ESI, 1.8%, 15.7%, 38.4%, 42.5%, and 1.6% were assigned to levels 1, 2, 3, 4, and 5, respectively. The percentage of each level using KTAS was similar to using ESI. Significant consistency existed in TAR and LOS compared with KTAS and ESI. CONCLUSION: KTAS seems preferable to triaged patients according to severity. It is helpful to order of priority in utilization for ED.
Subject(s)
Adult , Humans , Emergencies , Emergency Service, Hospital , Length of Stay , Prospective Studies , Tertiary Care Centers , TriageABSTRACT
BACKGROUND: The purpose of triage is to identify patients needing immediate resuscitation, to assign patients to a pre-designed patient care area, and to initiate diagnostic/therapeutic measures as appropriate. This study aimed to use emergency severity index (ESI) in a pediatric emergency room. METHODS: From July 2006 to August 2010, a total of 21904 patients visited the International Department of Beijing Children's Hospital. The ESI was measured by nurses and physicians, and compared using SPSS. RESULTS: Nurses of the hospital took approximately 2 minutes for triage. The results of triage made by nurses were similar to those made by doctors for ESI in levels 1-3 patients. This finding indicated that the nurses are able to identify severe pediatric cases. CONCLUSION: In pediatric emergency rooms, ESI is a suitable tool for identifying severe cases and then immediate interventions can be performed accordingly.
ABSTRACT
Objective Demonstrate the implication of Emergency Severity Index (ESI) in pediatric emergency room (ER). Method ESI categories of 21 904 visitors to ER of Beijing Children's Hospital's international department were reviewed. SPSS statistic software was employed to compare the results of ESI categories by doctors and nurses separately using x2 analysis. Results There are highly consistency in ESI categories by doctors and nurses. ESI is an easy-learned and effective triage method. Conclusions ESI is capable in pediatric emergency room regarding recognizing serious cases and saving clinical resources.