Search results for "triage"
showing 10 items of 43 documents
Triage and Allocation of Neurocritical Care Resources During the COVID 19 Pandemic - A National Survey
2021
Objective: In light of the ongoing COVID-19 pandemic and the associated hospitalization of an overwhelming number of ventilator-dependent patients, medical and/or ethical patient triage paradigms have become essential. While guidelines on the allocation of scarce resources do exist, such work within the subdisciplines of intensive care (e.g., neurocritical care) remains limited.Methods: A 16-item questionnaire was developed that sought to explore/quantify the expert opinions of German neurointensivists with regard to triage decisions. The anonymous survey was conducted via a web-based platform and in total, 96 members of the Initiative of German Neurointensive Trial Engagement (IGNITE)-stud…
Comprehensive cardiovascular ECG-gated MDCT as a standard diagnostic tool in patients with acute chest pain
2007
Acute myocardial infarction, pulmonary embolism, and aortic dissection are diseases associated with acute chest pain and may lead to severe morbidity and mortality. These diseases may not be trivial to diagnose in the settings of emergency room. ECG-gated multi-detector computed tomography (MDCT), already established for the assessment of pulmonary embolism and aortic dissection, provides reliable information regarding the triage of patients with acute coronary syndrome in the emergency room. MDCT recently appeared to be logistically feasible and a promising comprehensive method for the evaluation of cardiac and non-cardiac chest pain in emergency department patients. The possibility to sca…
Accuracy of risk tools to predict critical bleeding in major trauma: A systematic review with meta-analysis.
2021
BACKGROUND Early detection of critical bleeding by accurate tools can help ensure rapid delivery of blood products to improve outcomes in major trauma patients. We conducted a systematic review to evaluate the accuracy of risk tools to predict critical bleeding in patients with major trauma. METHODS PubMed, Embase, and CENTRAL were searched up to February 2021 for studies investigating risk tools to predict critical bleeding for major trauma people in prehospital and emergency department. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis of Diagnostic Test Accuracy study guidelines. Two independent authors included studies, extracted data, appraised the quali…
Accurate Triage of Oncological Patients for Safely Continuing Cancer Therapy During the SARS-CoV-2 Pandemic
2021
ObjectiveTo evaluate the efficacy of clinical triage of oncological patients for safe continuation of cancer therapy implemented during the first SARS-CoV-2 outbreak.MethodsBetween 25 February and 21 April 2020, patients attending the Medical Oncology Unit, Spedali Civili Hospital, Brescia (Italy) for cancer therapy underwent triage to identify those with no signs and symptoms suspicious for SARS-CoV-2 infection in which antineoplastic treatment could be continued as scheduled. Triage questions investigated common symptoms (e.g., fever, cough, dyspnea, anosmia, dysgeusia, headache, nasal congestion, conjunctival congestion, sore throat, diarrhea, nausea and vomiting); body temperature and p…
Accuracy of pre-hospital triage tools for major trauma: a systematic review with meta-analysis and net clinical benefit
2021
Abstract Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital triage tools for major trauma in the context of the development of the Italian National Institute of Health guidelines on major trauma integrated management. Methods PubMed, Embase, and CENTRAL were searched up to November 2019 for studies investigating pre-hospital triage tools. The ROC (receiver operating characteristics) curve and net clinical benefit for all selected triage tools were performed. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies–2. Certainty of the evidence was judged with the Grading of Recommendations Assessment, Developme…
Rationing in a Pandemic: Lessons from Italy.
2020
In late February and early March 2020, Italy became the European epicenter of the COVID-19 pandemic. Despite increasingly stringent containment measures enforced by the government, the health system faced an enormous pressure, and extraordinary efforts were made in order to increase overall hospital beds’ availability and especially ICU capacity. Nevertheless, the hardest-hit hospitals in Northern Italy experienced a shortage of ICU beds and resources that led to hard allocating choices. At the beginning of March 2020, the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) issued recommendations aimed at supporting physicians in prioritizing patients when …
0139 : Extrahospital troponin measurement before admission for a ST segment elevation myocardial infarction
2016
International audience; Background and aimEarly and reliable triage of patients is of major importance to promote rapid and appropriate treatments of patients with ST segment elevation myocardial infarction (STEMI). Extrahospital troponin measurement is used in primary care setting to help the identification of patients with suspected MI. From a regional survey (RICO), we aimed to investigate the frequence and hospital prognosis of STEMI patients with prehospital troponin (PT) measurement.Methods and resultsProspective study on 799 consecutive patients with STEMI included in RICO from March 2013 – 31 may 2015. Among the 799 patients, 38(5%) were identified with PT, from source files and pat…
Neutrophil CD64 as a marker of infection in patients admitted to the emergency department with acute respiratory failure
2014
Andrea Cortegiani, Vincenzo Russotto, Francesca Montalto, Grazia Foresta, Pasquale Iozzo, Santi Maurizio Raineri, Antonino Giarratano Department of Biopathology and Medical and Forensic Biotechnologies (DIBIMEF), Section of Anesthesiology, Analgesia, Emergency and Intensive Care, Policlinico “P Giaccone”, University of Palermo, Palermo, Italy Introduction: Cluster of differentiation 64 (CD64) is expressed on neutrophils during bacterial infections and sepsis. The aim of our study was to assess the CD64 expression in patients admitted to the emergency department (ED) with a triage diagnosis of acute respiratory failure (ARF) and/or dyspnea and to verify a relationship bet…
Triage assessment of registered nurses in the emergency department
2013
Standardised triage systems have been implemented in emergency departments (EDs) to improve the efficacy of assessment strategies as performed by registered nurses (RNs). However, the exact effect the standardised triage systems have on the decision-making process remains unclear.Aim: To evaluate decision making in the triage setting before and after implementation of the Medical Emergency Triage and Treatment System Adult in one hospital's ED.Methods: A descriptive intervention design with a quantitative approach. A total of 655 patients before and 413 patients after the intervention were included. A questionnaire was used to evaluate how the RNs assessed the patients before intervention w…
Scoresysteme in der Notfallmedizin?
1994
The primary goals of scoring in emergency medicine are grading of the severity of the patient's condition, measurement of diagnostic and therapeutic efforts, forecasting the outcome, and support in decision making on triage and therapy. Scores can also be used as tools for measuring efficacy and controlling quality. There has been less experience with use of scoring systems to estimate quality of life. The ability to make a prognosis in an individual case is the most critical point; a score may support decisions on therapy in very specific situations only. Scores for use in emergency medicine should be based on physiological parameters, universally applicable and suitable for use throughout…