EMPodSA-07-Triage Introduction
Nurses’ and doctors’ perceptions regarding the implementation of a triage system in an emergency unit in South Africa
Abstract
Triage assessment of patients on arrival at an emergency unit is an essential function in quality emergency care provision, and is a cost-effective and time saving venture. This study investigated nurses’ and doctors’ perceptions about the implementation of the Cape Triage Score in one emergency unit. The challenges encountered prior to the implementation of the Cape Triage Score and the roles and core competencies of the triage nurse were addressed as well as the strengths and weaknesses of the Cape Triage Score.
A procedure based alternative to the injury severity score for major incident triage of children: results of a Delphi consensus process
ABSTRACT
Background: Triage at the site of a major incident is key to effective scene management. A number of triage algorithms have been suggested to assist the triage officer to determine triage priorities. However, many advocated scores were not specifically developed for use in major incidents, nor are they designed for multiple age groups.
Many of these algorithms have not been validated: those that have were validated against the Injury Severity Score, which is of little relevance in a major incident—it is the urgency of medical intervention that is of importance in this setting. Keep Reading
Validation of the Paediatric Triage Tape
ABSTRACT
Introduction: The Paediatric Triage Tape (PTT) is an easy to use major incident primary triage tool, based upon a modification of the Triage Sieve. The purpose of this study was to prospectively validate the PTT for use in paediatric major incidents. Keep Reading
The cape triage score: a new triage system South Africa. Proposal from the cape triage group
ABSTRACT
The Cape Triage Group (CTG) convened with the intention of producing a triage system for the Western Cape, and eventually South Africa. The group includes in-hospital and prehospital staff from varied backgrounds. The CTG triage protocol is termed the Cape Triage Score (CTG), and has been developed by a multi-disciplinary panel, through best available evidence and expert opinion. The CTS has been validated in several studies, and was launched across the Western Cape on 1 January 2006.
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.
Effect of introduction of nurse triage on waiting times in a South African emergency department
ABSTRACT
Background: In a resource poor setting with poverty, a high burden of disease and critically low medical staff numbers, triage could potentially improve the long waiting times experienced at South African public hospital emergency departments (ED) and render timely emergency care to those in most need. Keep Reading
Limitations in validating emergency department triage scales
ABSTRACT
Objective: To examine whether current validation methods of emergency department triage scales actually assess the instrument’s validity.
Methods: Optimal methods of emergency department triage scale validation are examined in developed countries and their application to developing countries is considered.
Results and conclusion: Numerous limitations are embedded in the process of validating triage scales. Methods of triage scale validation in developed countries may not be appropriate and repeatable in developing countries. Even in developed countries there are problems in conceptualising validation methods. A new consensus building validation approach has been constructed and recommended for a developing country setting. The Delphi method, a consensual validation process, is advanced as a more appropriate alternative for validating triage scales in developing countries.
A prospective evaluation of the Cape triage score in the emergency department of an urban public hospital in South Africa
ABSTRACT
Background: Until recently South Africa had no triage system for emergency department (ED) use. The Cape triage group developed a triage scale called the Cape triage score (CTS). This system consists of a basic physiology score, mobility score and a short list of important discriminators that cannot be accurately triaged on a physiological score alone. Highest priority is given to a red colour code, followed by orange, yellow and green. Keep Reading