Triage method for out-of-hospital poisoned patients.
The aim of this study was to develop and evaluate a triage method to prevent unnecessary emergency department visits of out-of-hospital poisoned patients. From October 2003 to September 2004, the calls that lay persons gave to the Seoul Emergency Medical Information Center to seek advice on the out-of-hospital poisoned patients were enrolled. We designed a triage protocol that consisted of five factors and applied it to the patients. According to the medical outcomes, we classified the patients into two groups, the toxicity-positive and the toxicity-negative. We arranged the factors on the basis of the priority that was determined in order of the odds ratio of each factor for the toxicity-positive and made a flow chart as a triage method. Then we calculated a sensitivity, specificity, positive predictive value and negative predictive value of the method. We regarded the specificity as the ability of the method and the sensitivity as the safety. A total of 220 patients were enrolled in this study. The method showed a sensitivity, specificity, positive predictive value, and negative predictive value of 99.2%, 53.4%, 76.2%, and 97.9%, respectively. Our triage method prevented 53.4% of the unnecessary emergency department visits of out-of-hospital acutely poisoned patients, safely.
Kwon
Woon Yong
WY
Department of Emergency Medicine, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul, Korea.
Rhee
Joong Eui
JE
Gang
Hong Seong
HS
Shin
Sang Do
SD
Cho
Jun Hwi
JH
Song
Hyoung Gon
HG
Suh
Gil Joon
GJ
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D003663:Decision Trees; D004632:Emergency Medical Services / Q000379:methods / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D011041:Poisoning / Q000175:diagnosis* / Q000628:therapy*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017216:Telemedicine / Q000379:methods / Q000458:organization & administration*; D013689:Telephone; D014218:Triage / Q000379:methods / Q000458:organization & administration*