Triage decisions differ for paramedics and physicians

(HealthDay) -- Real-time emergency room triage decisions by paramedics agree with the triage decisions of emergency residents about half the time, according to a study published in the July issue of the Journal of Emergency Nursing.

Fatih Ozan Kahveci, M.D., from the Karaelmas University Hospital in Zonguldak, Turkey, and colleagues analyzed the agreement of triage decisions between paramedics and emergency residents using the three-level (3L) triage scale and the five-level (5L) Australian triage scale. Data were analyzed for 731 patients who presented to a central triage area of an emergency department and urgent care center of a university teaching hospital in Turkey during a one-week period.

The researchers found that the agreement between triage decisions was 47 percent for the 3L triage scale and 45 percent for the 5L triage scale. In the triage area the admitting time and waiting time were consistent. There was a robust correlation between the patient's general condition and both triage scales.

"We found that a real-time triage evaluation elicited a lower level of agreement than did paper-based scenarios, probably because the major limitation of written scenarios is the lack of visual and aural cues associated with real patients," Kahveci and colleagues conclude. "A new triage scale may be necessary for untrained personnel so that all emergency departments can conduct simple triage."