Emergency medicine journal : EMJ
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Multicenter Study
Reliability and validity of the Manchester Triage System in a general emergency department patient population in the Netherlands: results of a simulation study.
To assess the reliability and validity of the Manchester Triage System (MTS) in a general emergency department patient population. ⋯ Inter-rater reliability is "moderate" to "substantial" and test-retest reliability is high. The reliability of the MTS is not influenced by nurses' work experience. Undertriage mainly occurs in the MTS categories orange and yellow. The MTS is more sensitive for children who need immediate or urgent care than for other patients in the emergency department.
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In a resource poor setting with poverty, a high burden of disease and critically low medical staff numbers, triage could potentially improve the long waiting times experienced at South African public hospital emergency departments (ED) and render timely emergency care to those in most need. ⋯ The results demonstrate that use of the CTS, as implemented by trained nurses, dramatically reduced the waiting time of patients attending a busy public hospital ED in South Africa.
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Multicenter Study Comparative Study
Emergency department staffing in England and Wales, April 2007.
To determine medical and nursing staffing levels in emergency departments in England and Wales. ⋯ There is great variability in staffing numbers in similar-sized departments, and most departments are understaffed in comparison with the recommendations of the British Association for Emergency Medicine to achieve the 4 h target at the 90% level.
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Preclinical actions in the primary assessment of victims of blunt trauma may prolong the time to definitive clinical care. The aim of this study was to examine the duration of performed interventions and to study the effect of on-scene time (OST) and interventions performed before admission to hospital on hospital resuscitation time. ⋯ For most trauma patients the initial life- and limb-saving care is achieved within the "golden hour". Prehospital treatment occupies most of the golden hour. More prehospital interventions were performed with HEMS than with EMS only, but the higher number of interventions did not result in a longer OST with HEMS. Although the numbers of subsequent in-hospital interventions may be lower, no reduction in time in hospital may be expected from the interventions performed before hospital admission.