Document Detail


Refining Emergency Severity Index triage criteria.
MedLine Citation:
PMID:  15930399     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The Emergency Severity Index (ESI) version 3 is a five-level triage acuity scale with demonstrated reliability and validity. Patients are rated from ESI level 1 (highest acuity) to ESI level 5 (lowest acuity). Clinical experience has demonstrated two levels of ESI level 2 patients: those who require immediate intervention and those who are stable to wait for at least ten minutes. Studies have found that few patients are rated ESI level 1, and it has been suggested that revisions to the ESI might result in appropriate reclassification of some sickest level 2 patients as level 1. The purpose of this study was to identify level 2 patients who might be reclassified as level 1 patients. METHODS: This was a multisite, prospective study. The authors identified ESI level 2 patients who required immediate, lifesaving intervention and calculated chi-square statistics and odds ratios for variables that predicted which ESI level 2 patients actually received immediate intervention. RESULTS: Immediate lifesaving interventions were provided for 117 (20.2%) of the 589 patients included in the study. Seventeen predictors of the need for immediate intervention were identified. The strongest predictor was the triage nurse's judgment of the need for immediate intervention, especially airway and medications. CONCLUSIONS: Specific clinical findings at triage for a subset of ESI level 2 patients were associated with immediate delivery of lifesaving interventions. Revisions to the ESI level 1 criteria may be beneficial.
Authors:
Paula Tanabe; Debbie Travers; Nicki Gilboy; Alex Rosenau; Gina Sierzega; Valerie Rupp; Zoran Martinovich; James G Adams
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  12     ISSN:  1553-2712     ISO Abbreviation:  Acad Emerg Med     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-02     Completed Date:  2006-03-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  497-501     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Institute for Health Services Research and Policy Studies, Northwestern University, Chicago, IL, USA. p-tanabe@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Confidence Intervals
Emergency Medicine / methods,  statistics & numerical data
Emergency Nursing / instrumentation*,  statistics & numerical data
Female
Humans
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Prospective Studies
Reproducibility of Results
Severity of Illness Index*
Triage / standards*,  statistics & numerical data
Comments/Corrections
Comment In:
Acad Emerg Med. 2005 Jun;12(6):533-5   [PMID:  15930405 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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