Emergency Department Triage Decisions: Personnel and Parameters

Onur POLAT, Sinan GENÇ, Ayça KOCA TANRIVERDİ, Serdar GÜRLER, Müge GÜNALP ENEYLİ, Ahmet Burak OĞUZ, Atilla Halil ELHAN

Özet

, Serdar Gürler1 , Sinan Genç1 , Ahmet Burak Oğuz1 ,Ahmet Burak Oğuz1

Abstract

Objectives: Triage aims to determine the clinical priority of patients based on their presenting features. Scoring systems-including physiologicalparameters-to predict mortality have been described, but in most triage methods used in emergency departments, vital signs or laboratory parametersare not included as standard assessments. The objective of this study was to measure agreement and acuity on the urgency of an emergencydepartment patient between the points of views of healthcare professionals. We also sought to determine which vital signs and parameters affecttriage decision by creating several mods with different parameters.Materials and Methods: This prospective study was carried out on 550 patients referred to an academic emergency department. The patients triagelevels were determined by nurses, intern doctors, residents and emergency physicians. Eleven mods were defined with several components, for eachmod 50 patients were selected. To evaluate the agreement between raters triage decisions, the chance-adjusted measure of agreement kappa wascalculated.Results: Of the 550 patients included in the study, agreement for nurses was 0.374, kappa value between interns and physician was 0.257, and avalue of 0.311 was found for residents.Conclusion: In emergency medicine, there is a strong need for sensitive tools to identify and characterize patients at admission to the emergency department. According to our results, the most important parameters affecting triage decision were found to be oxygen saturation and Glasgow Coma scale.