AAEM vs ACEP What Are the Issues, Part 1
40 Years on the Frontline, part 2
40 Years on the Frontline, part 1
State of emergency medicine in South Africa
Abstract
Introduction: Emergency medicine is a new speciality in South Africa. It was first registered in 2003, and there are now 30 specialists in the country, with 10 new graduates from local registrar training programmes and over 40 trainees on four programmes across the country. Keep Reading
Emergency department procedural sedation practice in Cape Town, South Africa
Abstract
Background: There are no general policies or protocols for procedural sedation in the emergency department and no literature on present practice in South Africa. Keep Reading
Comparison of paediatric major incident primary triage tools
ABSTRACT
Objectives: To determine the sensitivity and specificity of paediatric major incident triage scores. The Paediatric Triage Tape (PTT), Careflight, Simple Triage and Rapid Treatment (START), and JumpSTART systems were tested.
Methods: In total, 3461 children presenting to a South African emergency department with trauma were scored using the four different methods. The sensitivity and specificity of the four scores was calculated against the Injury Severity Score (ISS), New ISS (NISS), and a modification of the Garner criteria (a measure of need for urgent clinical intervention). We also performed a Bayesian analysis of the scores against three different types of major incident.
Results: None of the tools showed high sensitivity and specificity. Overall, the Careflight score had the best performance in terms of sensitivity and specificity. The performance of the PTT was very similar. In contrast, the JumpSTART and START scores had very low sensitivities, which meant that they failed to identify patients with serious injury, and would have missed the majority of seriously injured casualties in the models of major incidents.
Conclusion: The Careflight or PTT methods of triage should be used in paediatric major incidents in preference to the jumpSTART or START methods.