M Möckel1,2, S Reiter3, T Lindner3, A Slagman3,4. 1. Notfall- und Akutmedizin - Zentrale Notaufnahmen und Chest Pain Units, Campus Virchow-Klinikum und Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. martin.moeckel@charite.de. 2. College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australien. martin.moeckel@charite.de. 3. Notfall- und Akutmedizin - Zentrale Notaufnahmen und Chest Pain Units, Campus Virchow-Klinikum und Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. 4. College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australien.
Abstract
BACKGROUND: "Triage" means the primary assessment of a previously unknown patient with an acute health disorder, initially considered a medical emergency. The initial triage is part of the primary assessment, which also includes the registration of administrative data and patient's mode of arrival. OBJECTIVES: The aim of the work is to provide an overview of frequently used structured primary assessment tools and the underlying evidence for their use in the emergency room. METHODS: Based on a systematic literature search in PubMed, 41 articles were selected according to predefined criteria. RESULTS: The most frequently used primary assessment systems in Germany are the Emergency Severity Index (ESI) and the Manchester Triage System (MTS). Scientific evidence exists for the accuracy and reliability of the primary assessment with these instruments. However, there are no gold standards for measuring urgency, so that separate criteria must be defined. Sufficient data to determine a treatment sector or the necessary staffing levels are lacking. CONCLUSIONS: Structured primary assessment using formalized systems alone is inadequate to categorize the urgency of emergency and acute patients. In fact, a combination of different measures in an interprofessional team is required. Primary assessment systems and processes generally do not allow patients to be referred to downstream structures without a thorough medical examination.
BACKGROUND: "Triage" means the primary assessment of a previously unknown patient with an acute health disorder, initially considered a medical emergency. The initial triage is part of the primary assessment, which also includes the registration of administrative data and patient's mode of arrival. OBJECTIVES: The aim of the work is to provide an overview of frequently used structured primary assessment tools and the underlying evidence for their use in the emergency room. METHODS: Based on a systematic literature search in PubMed, 41 articles were selected according to predefined criteria. RESULTS: The most frequently used primary assessment systems in Germany are the Emergency Severity Index (ESI) and the Manchester Triage System (MTS). Scientific evidence exists for the accuracy and reliability of the primary assessment with these instruments. However, there are no gold standards for measuring urgency, so that separate criteria must be defined. Sufficient data to determine a treatment sector or the necessary staffing levels are lacking. CONCLUSIONS: Structured primary assessment using formalized systems alone is inadequate to categorize the urgency of emergency and acute patients. In fact, a combination of different measures in an interprofessional team is required. Primary assessment systems and processes generally do not allow patients to be referred to downstream structures without a thorough medical examination.
Entities:
Keywords:
Clinical decision making; Crowding; Emergency; Health care sector; Resuscitation
Authors: Anne Kristine Servais Iversen; Michael Kristensen; Rebecca Monett Østervig; Lars Køber; György Sölétormos; Jakob Lundager Forberg; Jesper Eugen-Olsen; Lars Simon Rasmussen; Morten Schou; Kasper Karmark Iversen Journal: Emerg Med J Date: 2018-10-16 Impact factor: 2.740
Authors: Michael Christ; Florian Grossmann; Daniela Winter; Roland Bingisser; Elke Platz Journal: Dtsch Arztebl Int Date: 2010-12-17 Impact factor: 5.594
Authors: D Brammen; F Greiner; M Kulla; R Otto; W Schirrmeister; S Thun; S E Drösler; J Pollmanns; S C Semler; R Lefering; V S Thiemann; R W Majeed; K U Heitmann; R Röhrig; F Walcher Journal: Med Klin Intensivmed Notfmed Date: 2020-12-21 Impact factor: 0.840
Authors: Florian Wallstab; Felix Greiner; Wiebke Schirrmeister; Markus Wehrle; Felix Walcher; Christian Wrede; Kirsten Habbinga; Wilhelm Behringer; Dominik Brammen Journal: BMC Emerg Med Date: 2022-01-11