title: Efficacy of triage by paramedics: a real-time comparison study.
abstract: OBJECTIVE
  Triage has evolved as an effective method of separating patients who require immediate medical attention from patients with non-urgent problems. The aim of this study was to assess the agreement between paramedics and emergency residents about triage decisions using the 3-level triage (3L) system and the 5-level (5L) Australian triage scale in real time.
  
  
  METHODS
  All patients who presented to a central triage area during a 1-week period were triaged by paramedics and emergency residents. The chance-adjusted measure of agreement kappa (κ) was calculated to evaluate the agreement between triage decisions made by paramedics and by emergency residents.
  
  
  RESULTS
  A total of 731 patients were included in the final data analysis. Admitting time and waiting time were significantly consistent in the triage area. Agreement between the triage decisions made by paramedics and by emergency residents was 47% (κ = 0.47) when using the 3L triage scale and 45% (κ = 0.45) when using the 5L triage scale across all cases. A strong correlation existed among the general conditions of the patients, the 3L triage scale, and the 5L triage scale.
  
  
  CONCLUSIONS
  Triaging is commonly performed by nurses in the American emergency system, and triage by paramedics is not common. Few studies are available about triage by paramedics, and more studies are necessary. A new triage scale may be necessary for untrained personnel so that all emergency departments can conduct simple triage.
authors.affiliation: Department of Emergency Medicine, Karaelmas University Hospital, Zonguldak, Turkey. drozankahveci@gmail.com
authors.forename: Fatih Ozan
authors.initials: FO
authors.lastname: Kahveci
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demircan
authors.forename: Ayfer
authors.initials: A
authors.lastname: Keles
authors.forename: Fikret
authors.initials: F
authors.lastname: Bildik
authors.forename: Sahender Gülbin
authors.initials: SG
authors.lastname: Aygencel
mesh_terms: D000328:Adult; D003657:Decision Making; D004634:Emergency Medical Technicians; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D014218:Triage / Q000458:organization & administration; D000078329:Workforce; D055815:Young Adult