A multicenter study on reliability and validity of a new triage system: the Triage Emergency Method version 2

In Italy there are many triage guidelines and methods based on consensus. But, to our knowledge, there are few data on the reliability and predictive validity of triage systems adopted by Italian emergency departments. The Triage Emergency Method version 2 (TEM v2) is a new four-level in-hospital triage system. This paper presentes a before-and-after observational study performed using triage scenarios from June 2008 to September 2009 in 6 Italian emergency departments. Twelve nurses who received a 5-h training on TEM and a panel of experts on TEM assigned priority code to 66 scenarios. To test the inter-rater reliability among participants and the panel of experts (before and after the course), we used the weighted K statistic. We assessed the validity of TEM by calculating sensitivity, specificity and accuracy for predicting the reference standard's triage score. The TEM v2 showed good and very-good agreement among all 6 groups of nurses with a K range=0.61-1. Also, sensitivity, specificity and accuracy of nurses' triage rating for predicting the reference standard's triage code was good (accuracy range=78-90%). In this multicenter study, TEM v2 has a good inter-rater reliability for rating triage acuity among all groups of participating nurses, with a K value similar to the reference standard reliability (K=0.75). Thus, the Triage Emergency Method version 2 seems to be valid and accurate in predicting a reference standard rating

Diagnosis and risk stratification of chest pain patients in the emergency department: focus on acute coronary syndromes. A position paper of the Acute Cardiovascular Care Association.

This paper provides an update on the European Society of Cardiology task force report on the management of chest pain. Its main purpose is to provide an update on the decision algorithms and diagnostic pathways to be used in the emergency department for the assessment and triage of patients with chest pain symptoms suggestive of acute coronary syndromes

The Role of WestJEM in Promoting International Emergency Medicine

[WestJEM. 2009;10(4):225-226.

The globalization of emergency medicine and its importance for public health.

Emergency medicine (EM) is a global discipline that provides secondary disease prevention and is also a tool for primary prevention. It is a horizontally integrated system of emergency care consisting of access to EM care; provision of EM care in the community and during transportation of patients; and provision of care at the receiving facility or hospital emergency department. EM can offer many tools to improve public health. These tools include primary disease prevention; interventions for addressing substance abuse and interpersonal violence; education about safety practices; epidemiological surveillance; enrolment of patients in clinical research trials focusing on acute interventions; education and clinical training of health-care providers; and participation in local and regional responses to natural and man-made disasters. Public health advocates and health policy-makers can benefit from the opportunities of EM and can help overcome its challenges. Advocating the establishment and recognition of the specialty of EM worldwide can result in benefits for health-care education, help in incorporating the full scope of EM care into the system of public health, and expand the capabilities of EM for primary and secondary prevention for the benefit of the health of the public

The Role of WestJEM in Promoting International Emergency Medicine

[WestJEM. 2009;10(4):225-226.

European Society For Emergency Medicine position paper on emergency medical systems' response to COVID-19

The 2019 novel coronavirus acute respiratory epidemic is creating a stressed situation in all the health systems of the affected countries. Emergency medical systems and specifically the emergency departments as the front line of the health systems are suffering from overload and severe working conditions, the risk of contagion and transmission of the health professionals adds a substantial burden to their daily work. Under the perspective of European Society For Emergency Medicine, the recommendations provided by the health authorities are reviewed focus on the emergency department's activity.status: publishe

A multicenter study on reliability and validity of a new triage system: the Triage Emergency Method version 2

In Italy there are many triage guidelines and methods based on consensus. But, to our knowledge, there are few data on the reliability and predictive validity of triage systems adopted by Italian emergency departments. The Triage Emergency Method version 2 (TEM v2) is a new four-level in-hospital triage system. This paper presentes a before-and-after observational study performed using triage scenarios from June 2008 to September 2009 in 6 Italian emergency departments. Twelve nurses who received a 5-h training on TEM and a panel of experts on TEM assigned priority code to 66 scenarios. To test the inter-rater reliability among participants and the panel of experts (before and after the course), we used the weighted K statistic. We assessed the validity of TEM by calculating sensitivity, specificity and accuracy for predicting the reference standard’s triage score. The TEM v2 showed good and very-good agreement among all 6 groups of nurses with a K range=0.61-1. Also, sensitivity, specificity and accuracy of nurses’ triage rating for predicting the reference standard’s triage code was good (accuracy range=78-90%). In this multicenter study, TEM v2 has a good inter-rater reliability for rating triage acuity among all groups of participating nurses, with a K value similar to the reference standard reliability (K=0.75). Thus, the Triage Emergency Method version 2 seems to be valid and accurate in predicting a reference standard rating