Triage is an integral part of the modern emergency department. The use of a recognised triage system has many advantages for the emergency department including reference to a recognised decision-making structure and support in the form of a professionally accepted and validated system. As part of a programme of internal change the Manchester triage system (MTS) was introduced to an emergency department in the Republic of Ireland. This article outlines the introduction of this method of triage and cites the domestic and international drivers of the change.
"The most commonly used guidelines for ED triage on the international literature are The Manchester Triage Score [17,28,29], The Canadian Triage and Acuity Scale [28-31], The Australasian Triage Scale [28,32] and Emergency severity Index [27,29]. In ESI, there are five-levels of these triage score (see Figure 1). "
[Show abstract][Hide abstract] ABSTRACT: Emergency departments across the globe follow a triage system in order to cope with overcrowding. The intention behind triage is to improve the emergency care and to prioritize cases in terms of clinical urgency.
In emergency department triage, medical care might lead to adverse consequences like delay in providing care, compromise in privacy and confidentiality, poor physician-patient communication, failing to provide the necessary care altogether, or even having to decide whose life to save when not everyone can be saved. These consequences challenge the ethical quality of emergency care. This article provides an ethical analysis of "routine" emergency department triage. The four principles of biomedical ethics - viz. respect for autonomy, beneficence, nonmaleficence and justice provide the starting point and help us to identify the ethical challenges of emergency department triage. However, they do not offer a comprehensive ethical view. To address the ethical issues of emergency department triage from a more comprehensive ethical view, the care ethics perspective offers additional insights.
We integrate the results from the analysis using four principles of biomedical ethics into care ethics perspective on triage and propose an integrated clinically and ethically based framework of emergency department triage planning, as seen from a comprehensive ethics perspective that incorporates both the principles-based and care-oriented approach.
BMC Emergency Medicine 10/2011; 11(1):16. DOI:10.1186/1471-227X-11-16
"The fundamental aim of triage is to ensure that patients presenting to an ED are treated in the order of clinical urgency . It is essential that chest pain linked to possible cardiac causes is accurately identified at this stage and is appropriately accorded a high clinical priority. "
[Show abstract][Hide abstract] ABSTRACT: The chest pain unit (CPU) provides a service for patients at moderate-to-low risk for acute coronary syndrome (ACS). Although the number of CPUs has continued to grow worldwide, little has been written on the specific role and contribution of nursing in CPUs. The stay of patients in the CPU can be divided into six stages: triage, diagnosis, treatment, observation/monitoring, discharge, and follow-up. CPU nurses are in a unique position to promote evidence-based practice during all of these stages. Deeper insight into the unique role of nurses in CPUs will promote understanding of what type of knowledge, skills, and attitudes are required to provide the services that will contribute to improved quality of care for chest pain patients.
European Journal of Cardiovascular Nursing 01/2008; 6(4):265-72. DOI:10.1016/j.ejcnurse.2007.01.095 · 1.88 Impact Factor
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