Simple Triage Algorithm and Rapid Treatment and Sort, Assess, Lifesaving, Interventions, Treatment, and Transportation mass casualty triage methods for sensitivity, specificity, and predictive values Mary Colleen Bhalla, Jennifer Frey, Cody Rider, Michael Nord, Mitch Hegerhorst
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.021
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: August 13 2015
x Two common mass casualty triage algorithms are Simple Triage Algorithm and Rapid Treatment (START) and Sort, Assess, Lifesaving, Interventions, Treatment, and Transportation (SALT). We sought to determine the START and SALT efficacy in predicting clinical outcome by appropriate triage.
Association of triage time Shock Index, Modified Shock Index, and Age Shock Index with mortality in Emergency Severity Index level 2 patients Mehdi Torabi, Amirhossein Mirafzal, Azam Rastegari, Neda Sadeghkhani
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.014
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: September 19 2015
x Shock Index (SI) is considered to be a predictor of mortality in many medical and trauma settings. Many studies have shown its superiority to conventional vital sign measurements in mortality prediction.
Triage sepsis alert and sepsis protocol lower times to fluids and antibiotics in the ED Geoffrey E. Hayden, Rachel E. Tuuri, Rachel Scott, Joseph D. Losek, Aaron M. Blackshaw, Andrew J. Schoenling, Paul J. Nietert, Greg A. Hall
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.039
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: August 26 2015
x Early identification of sepsis in the emergency department (ED), followed by adequate fluid hydration and appropriate antibiotics, improves patient outcomes.
Direct cardiologist involvement in ED triage of cardiology patients Ken Monahan, William Bradham, Sean Collins, Michael Baker, Geoffrey Chidsey, C. Scott English, F. Andrew Gaffney, Raphael See, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.041
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: November 18 2015
x Emergency department (ED) evaluation of patients with cardiovascular complaints is a frequent, costly health care challenge [1]. As a complement to existing systems [2], testing modalities [3-6], and clinical tools [7,8] currently used to optimize ED evaluation and decision making in this population, direct input from a cardiologist may be useful.
Triage of children with headache at the ED: a guideline implementation study Veronica Balossini, Anna Zanin, Corinne Alberti, Yonathan Freund, Marion Decobert, Antonella Tarantino, Maria La Rocca, Laurence Lacroix, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.11.027
The American Journal of Emergency Medicine , Vol. 31 , Issue 4 ,
Published online: February 4 2013
x We present a multicenter validation of a modified Manchester Triage System (MTS) flowchart for pediatric patients who present with headache to the emergency department. A prospective observational study was conducted across 5 European pediatric emergency departments. The standard MTS headache flowchart and a modified MTS headache flowchart were tested in the participating centers, and results were compared with triage categories identified by either the physician at the end of the clinical examination or the reference classification matrix (RCM).
Elderly fall patients triaged to the trauma bay: age, injury patterns, and mortality risk Daniel Evans, Jonathan Pester, Luis Vera, Donald Jeanmonod, Rebecca Jeanmonod
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.044
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: July 28 2015
x Falls in the elderly are a significant cause of morbidity and mortality. We sought to better categorize this patient population and describe factors contributing to their falls.
Streamlined focused assessment with sonography for mass casualty prehospital triage of blunt torso trauma patients Hai Hu, Yarong He, Shu Zhang, Yu Cao
DOI: http://dx.doi.org/10.1016/j.ajem.2014.03.014
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: March 20 2014
x Without prompt medical attention and often expedient emergency surgery, earthquake victims having blunt torso trauma will experience increased mortality [1]. Rapid identification of necessary emergent medical vs surgical interventions is critically important. Accurate triage is a necessity, particularly with limited medical resources in the chaos after a mass casualty event. The Simple Triage and Rapid Treatment (START) triage method [2] sorts patients into 4 colored tag categories, dependent upon respiratory rate, perfusion (presence of radial pulse and capillary refill time), and mental status (response to commands): red (critically ill patients requiring immediate medical care), yellow (patients in urgent condition, which may receive delayed medical care), green (patients having minor injuries), and black (patients deceased or expectantly soon to be deceased) (Fig. 1).
Patients in pain that refuse acetaminophen at triage François Lecomte, Stéphanie Huet, Etienne Audureau, Valérie Guyerdet, Jean-Louis Pourriat, Yann-Erick Claessens
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.030
The American Journal of Emergency Medicine , Vol. 32 , Issue 4 ,
Published online: December 20 2013
x It is usually perceived that pain is under-evaluated and under-treated in the emergency department (ED) [1]. Nevertheless recent efforts have contributed to significantly reducing pain [2]. This includes the implementation of procedures for early delivery of analgesics beginning with nurse triage [3,4]. However it is currently unknown whether emergency patients accept early delivery of acetaminophen by triage nurses. Therefore we studied the prevalence and the factors for analgesic refusal at triage.
Utility of point-of-care testing in ED triage Olanrewaju A. Soremekun, Elizabeth M. Datner, Simon Banh, Lance B. Becker, Jesse M. Pines
DOI: http://dx.doi.org/10.1016/j.ajem.2012.07.025
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: October 22 2012
x Triage systems are commonly used in emergency departments (ED) to prioritize patients. Laboratory testing is not typically used to help risk-stratify patients at triage.
Effectiveness of arterial, venous, and capillary blood lactate as a sepsis triage tool in ED patients Julie Contenti, Hervé Corraze, Fabien Lemoël, Jacques Levraut
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.003
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: November 8 2014
x We evaluate the capacity of arterial (ABL), peripheral venous (VBL), and capillary (CBL) blood lactate concentration to early detect the presence of severe sepsis in patients admitted to the emergency department for a septic syndrome.
Color-coding triage and allergic reactions in an Italian ED Fabio Fabbian, Roberto Melandri, Gabriella Borsetti, Emanuele Micaglio, Marco Pala, Alfredo De Giorgi, Alessandra Mellozzi Menegatti, Arrigo Boccafogli, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.02.002
The American Journal of Emergency Medicine , Vol. 30 , Issue 5 ,
Published in issue: June 2012
x Emergency department (ED) crowding is an international public health problem. The mismatch in ED and hospital resources may cause long waiting times and delays in treatments [1] and exposes to preventable medical errors [2]. Moreover, ED crowding is associated with prolonged stay and increased risk of adverse drug events (ADEs), estimated in 3% increased odds for every hour in the ED [3]. Adverse drug reactions (ADRs) account for 3% to 6% of all hospital admissions and occur in 10% to 15% of hospitalized patients [4].
Utility of point-of-care ultrasound in acute management triage of earthquake injury Shu Zhang, Da Zhu, Zhi Wan, Yu Cao
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.009
The American Journal of Emergency Medicine , Vol. 32 , Issue 1 ,
Published online: November 11 2013
x Earthquake could leads to massive casualty and injury in a short period [1-3]. Rapid screening and proper initial management and transfer triage are critical for improving survival during earthquake [1,4,5]. Point-of-care (POC) ultrasound is a newly diagnostic method that has been widely applied during emergency practice [6,7]. Several reports have shown the potential role of POC ultrasound in evaluation earthquake injury [8-10]. In April 20, 2013, a 7.3 magnitude earthquake struck the Sichuan Lu-Shan city (Epicenter location), causing more than 200 deaths and 10 000 injuries.
Non-invasive blood pressure and cardiac index measurements using the Finapres Portapres in an emergency department triage setting Yuri van der Does, Lex M. van Loon, Jelmer Alsma, Annebel Govers, Benno Lansdorp, Pleunie P.M. Rood, Stephanie C.E. Schuit
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.004
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: May 20 2013
x Emergency department (ED) patients are triaged to determine the urgency of care. The Finapres Portapres (FP) measures blood pressure (BP) and cardiac output (CO) non-invasively, and may be of added value in early detection of patients at risk for hemodynamic compromise.
Prehospital ultrasound thoracic examination to improve decision making, triage, and care in blunt trauma Pierre-Marie Brun, Jacques Bessereau, Daniel Levy, Xavier Billeres, Nathalie Fournier, Francois Kerbaul
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.063
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: January 9 2014
x Prehospital acute blunt thoracic trauma care remains difficult. Among then, diagnosis of atelectasis with ultrasound remains rare and unusual.
Cardiac risk factors and risk scores vs cardiac computed tomography angiography: a prospective cohort study for triage of ED patients with acute chest pain Ethan J. Halpern, Jacob P. Deutsch, Maria M. Hannaway, Adrian T. Estepa, Anand S. Kenia, Kenneth J. Neuburger, David C. Levin
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.001
The American Journal of Emergency Medicine , Vol. 31 , Issue 10 ,
Published online: September 12 2013
x The objective of the study is to evaluate cardiac risk factors and risk scores for prediction of coronary artery disease (CAD) and adverse outcomes in an emergency department (ED) population judged to be at low to intermediate risk for acute coronary syndrome.
Blood glucose levels as an adjunct for prehospital field triage Elon Glassberg, Ari M. Lipsky, Gadi Lending, Ilia Sergeev, Avishai Elbaz, Alexander Morose, Udi Katzenell, Nachman Ash
DOI: http://dx.doi.org/10.1016/j.ajem.2012.10.038
The American Journal of Emergency Medicine , Vol. 31 , Issue 3 ,
Published online: February 4 2013
x Elevated blood glucose levels (BGL) are known to be part of the physiologic response to stress following physical trauma. We aimed to study whether a measured BGL might help improve accuracy of field triage.
Ultrasound-assisted triage of ankle trauma can decrease the need for radiographic imaging Henrik Hedelin, Lars-Åke Goksör, Jon Karlsson, Stina Stjernström
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.005
The American Journal of Emergency Medicine , Vol. 31 , Issue 12 ,
Published online: October 23 2013
x An ankle sprain is a common injury, and patients are usually examined with plain radiographs to rule out a fracture despite the fact that only a small minority actually have one.
Clinical triage decision vs risk scores in predicting the need for endotherapy in upper gastrointestinal bleeding Farees T. Farooq, Michael H. Lee, Ananya Das, Rahul Dixit, Richard C.K. Wong
DOI: http://dx.doi.org/10.1016/j.ajem.2010.11.007
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: December 27 2010
x Acute upper gastrointestinal hemorrhage (UGIH) is a common reason for hospitalization with substantial associated morbidity, mortality, and cost. Differentiation of high- and low-risk patients using established risk scoring systems has been advocated. The aim of this study was to determine whether these scoring systems are more accurate than an emergency physician's clinical decision making in predicting the need for endoscopic intervention in acute UGIH.
Traditional nurse triage vs physician telepresence in a pediatric ED Greg P. Marconi, Todd Chang, Phung K. Pham, Daniel N. Grajower, Alan L. Nager
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.032
The American Journal of Emergency Medicine , Vol. 32 , Issue 4 ,
Published online: December 23 2013
x The objective of the study is to compare traditional nurse triage (TNT) in a pediatric emergency department (PED) with physician telepresence (PTP).
Using process indicators to optimize service completion of an ED drug and alcohol brief intervention program Joanna Akin, J. Aaron Johnson, J. Paul Seale, Gabriel P. Kuperminc
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.021
The American Journal of Emergency Medicine , Vol. 33 , Issue 1 ,
Published online: October 21 2014
x The strongest evidence for effectiveness of screening, brief intervention, and referral to treatment (SBIRT) programs is in primary care settings. Emergency department (ED) studies have shown mixed results. Implementation of SBIRT into ED settings is complicated by the type of patients seen and the fast-paced, high-throughput nature of the ED environment that makes it difficult to reach patients flagged for SBIRT services. This study uses data from an ED-based SBIRT program to examine the relationship between screen-positive rate, ED patient flow, and SBIRT service delivery.
