ABSTRACT
OBJECTIVE: The authors aimed to assess the repeatability of the Manchester Triage System (MTS) in children. METHODS: All emergency department nurses (n=43) from a general teaching hospital and a university children's hospital in The Netherlands triaged 20 written case scenarios using the Manchester Triage system. Second, at two emergency departments (EDs), real-life simultaneous triage of patients (<16 years) was performed by ED nurses and two research nurses. The written case scenarios and the patients included in the real-life simultaneous triage study were representative of children attending the ED, in age, problem and urgency level. The authors assessed inter-rater agreement using quadratic weighted kappa values. RESULTS: The weighted kappa between the nurses, triaging the case scenarios, was 0.83 (95% CI 0.74 to 0.91). In total, 88% (N=198) of the eligible ED patients were triaged simultaneously, with a weighted kappa of 0.65 (95% CI 0.56 to 0.72). CONCLUSIONS: The MTS showed good to very good repeatability in paediatric emergency care.
Subject(s)
Emergency Service, Hospital/standards , Triage/methods , Child , Hospitals, Pediatric/standards , Hospitals, Teaching/standards , Hospitals, University/standards , Humans , Netherlands , Nursing Staff, Hospital , Observer Variation , Reproducibility of Results , Triage/standardsABSTRACT
AIM: To assess the utility of bedside ultrasound performed by an emergency physician in adults undergoing diagnostic lumbar puncture. METHOD: Ultrasound was used as the primary means of determining the site of skin puncture, angle of needle advancement and depth needed to access the subarachnoid space. RESULTS: Cerebrospinal fluid was obtained from 36 of 39 patients (92.3%) in the first interspinous space attempted. CONCLUSIONS: The ultrasonographically measured depth of the dura mater correlates strongly with the final needle depth.
