Keywords
emergency severity index version 4
triage scale
How to Cite
Abstract
Background: Triage is a sorting of patients specific to the emergency department. Its objective is to optimize patient waiting time according to patient pathology or condition severity. The main scale used in France for triage is the French Emergency Nurses Classification (Classification Infirmière des Malades aux Urgences, CIMU). Currently, in our emergency department, triage nurses use the CIMU. As part of departmental reorganization, the triage scale was to be changed from the CIMU to the Emergency Severity Index (ESI).
The main objective of this study was to evaluate whether the use of the new triage scale significantly modified patient care
track orientation.
Methods: This was a single center, retrospective, observational study using medical file data collected over seven consecutive days chosen randomly. All patients in the emergency department during this period were included. Patient care track decisions were based on actual CIMU and proposed ESI version 4 results were noted for each patient: intensive care (IC), long track (L), and fast track (F). Patient care track decisions and scale results were compared using Pearson Chi2 tests.
Results: 1,181 patients were included. Results for the CIMU and the ESI respectively were: IC 94 (8%), L 485 (41%), F 583 (49%), and others 19 (2%), versus IC 86 (7%), L 242 (21%), and F 853 (72%). Patient care track decisions differed between the two scales (p < 0.001).
Conclusion: This study demonstrates that the use of ESI significantly changes patient care track decisions and therefore also patient care area assignments. The use of the ESI V4 scale will result in a more even distribution of patients between medical areas.
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