Computerized Triage System in the Emergency Department

ABSTRACT

PURPOSE: The existing triage systems for trauma at prehospital field sites have limitations when applied to various nontraumatic conditions at hospitals and show disagreement in inter- or intra-rater assessments. The purpose of study was to develop a simple and objective triage tool which could be applied to both traumatic and non-traumatic patients and would reduce the rate of disagreement in inter- or intra-rater assessments by using a computerized system. METHODS: A prospective study was designed to evaluate the characteristics and the outcomes of patients who visited Korea University Emergency Medical Center between April 1 and May 31, 2002. The observed parameters were age, sex, AVPU scale, mode of visit, and vital signs including blood pressure, pulse rate, respiratory rate, and body temperature. The patient's outcome, which reflected the severity of condition, was expressed on the basis of progress, including home discharge, admission to general ward, and admission to intensive care unit (ICU) or death. RESULTS: Of the 3,242 patients enrolled in the study, 724 were traumatic patients, and 2518 were non-traumatic patients. The accuracy rate between the actual and the calculated classification of a patient's outcome for all patients was 66.2% for discharge, 64.1% for admission to general ward, 30.6% for admission to ICU or death. The corresponding numbers for non-traumatic patients were 70.3%, 70.6%, 32.1%, and those for traumatic patients were 61.3%, 52.5%, 29.8%. CONCLUSION: The Computerized Triage System provides a useful guideline to classify patients into two groups (discharge vs admission), especially in non-traumatic conditions, but it has limitations for classifying into critically ill patients.