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Pre-hospital Care of Trauma Victims and Triaging on Arrival
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Ashish Aditya, Tanvir Samra, Anjuman Chander, Harshit Singla
Triage comes from the French verb trier, meaning “to sort”. Triage is the process of determining the priority of a patient's treatment based on the severity of injury or condition, or likelihood of recovery with or without treatment. Triage is an important tool where resources are limited, be it supplies or healthcare staff in developing countries such as India. Also, triage plays an important role in managing mass causalities, including natural disasters, explosions, accidents and similar events where a large number of injured victims congregate at a single or a few healthcare facilities.
Triage Algorithms
Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Triage refers to the sorting out and classification of patients and lesions to determine priority of need and proper place of treatment. Triage can be performed during skin cancer screenings using dermoscopy. Dermoscopy enables identifying lesions that are suspicious for skin cancer and aiding in the correct management decision. Deciding whether or not to biopsy a skin lesion is paramount during screening, whereas making a specific diagnosis, such as differentiating between basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma, is less important. For triage purposes, to decide which lesion(s) should be biopsied, several simplified dermoscopic algorithms have been proposed, most of which include asymmetry and color variation in their criteria1–4 (Table 5c.1).
Artificial Intelligence and Hospital Automation
Published in Salvatore Volpe, Health Informatics, 2022
When patients have cause to visit emergency departments, their first interaction is often triage. Accurate triage is essential because it quickly establishes the basics of patient condition and assigns a level of urgency to the timeline of care for that individual. Getting triage right means that the resources of an emergency department are appropriately meted to each patient in the proper order. At NYP, we have found that offering low-risk patients the option of telemedicine can be beneficial both in quicker care and discharge for those who choose it and in keeping our exam rooms open for the most urgent cases, where telemedicine would not be appropriate. I mention telemedicine, not because it is an example of AI, but because it is an example of technology improving patient experience by enhancing the ability of physicians to efficiently care for patients.
One-on-one comparison between qCSI and NEWS scores for mortality risk assessment in patients with COVID-19
Published in Annals of Medicine, 2022
Francisco Martín-Rodríguez, Ancor Sanz-García, Guillermo J. Ortega, Juan F. Delgado-Benito, Eduardo García Villena, Cristina Mazas Pérez-Oleaga, Raúl López-Izquierdo, Miguel A. Castro Villamor
During the first and second waves of the ongoing COVID-19 pandemic the initial patient/resource ratio was very high. This overload revealed the necessity of appropriate triage systems to apply the limited resources to critical patients. For instance, being classified as a high-risk patient (NEWS ≥ 7) is a strong predictor of early clinical impairment. Therefore, the use of scoring systems, such as NEWS, is critical to assist in initial triage, both at the scene and in the ED, helping to manage hospital and ICU admissions in a more efficient way, and to guide decisions on transfer to the ED. Nevertheless, its usefulness goes beyond this, because at extraordinary times like the present, it will allow us to know with certainty and in a simple way the short-term vital perspective of the patient. The availability of these scores will help the health system to better organize and manage limited resources, and also will allow us to inform the relatives of seriously ill patients of the possible outcome.
Enhancing satisfaction and respect for health care personnel: a mixed-methods case study of a community-based intervention
Published in Social Work in Health Care, 2022
Lubna Ansari Baig, Zaeema Ahmer, Hira Tariq, Mirwais Khan, Muhammad Naseem Khan, Muhammad Sohaib, Shiraz Shaikh
The interventions delivered key messages on “one attendant policy,” “triage,” “waiting time for patients at hospitals,” “media reporting,” and the “effects of violence on HCPs.” One attendant policy was explained in detail to the participants. It was explained how overcrowding at the hospitals can often lead to delayed work done by HCP. Importance of triage and assessing patients based on their clinical severity was emphasized upon. The participants were explained regarding reasons for the long waiting hours, especially at state-run hospitals. How the media reports events was also discussed in detail in these sessions. The mental health and the adverse outcomes faced by HCP as a result of being subjected to violence was communicated to the study participants as well. The intervention material is shown in Figure 1.
Triage Criteria: Medically, Ethically or Socially Defined?
Published in The American Journal of Bioethics, 2021
While triage protocols share a common goal—maximizing life by selecting patients who would most benefit from critical care—there are many variations in the selection of criterion to respond to situations of scarcity of resources. Unavoidably, discriminations are generated, that will be seen as more or less acceptable by different societies. Triage protocols cannot be value-neutral, as shown by numerous publications regarding the ethical challenges raised by triage criteria and scoring systems (Wynia and Sottile 2020). Wilkinson’s excellent paper addresses the ethical concerns raised by the use of frailty score (CFS) as a criterion for rationing intensive care during the COVID-19 pandemic. My purpose here is not to discuss the validity of the CFS criteria per se but to comment on the process by which triage criteria have been drafted and implemented, and the degree to which they were explicitly stated.