Refining Emergency Severity Index Triage Criteria.
Publication/Presentation Date
6-1-2005
Abstract
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.
Volume
12
Issue
6
First Page
497
Last Page
501
ISSN
1553-2712
Published In/Presented At
Tanabe, P., Travers, D., Gilboy, N., Rosenau, A., Sierzega, G., Rupp, V., & ... Adams, J. G. (2005). Refining Emergency Severity Index triage criteria. Academic Emergency Medicine: Official Journal Of The Society For Academic Emergency Medicine, 12(6), 497-501.
Disciplines
Emergency Medicine
PubMedID
15930399
Department(s)
Department of Emergency Medicine, Department of Emergency Medicine Faculty, Patient Care Services / Nursing
Document Type
Article