• Title/Summary/Keyword: triage

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The Development of the CAI Program and an Analysis of Its Effects, for the Learning of the Emergency Patient Triage (응급환자 중증도분류 학습을 위한 CAI프로그램 개발과 효과 분석)

  • 서영승
    • Korean Journal of Health Education and Promotion
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    • v.21 no.1
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    • pp.259-283
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    • 2004
  • This is an quasi experimental study using nonequivalent pre-test post-test control design for the development of the CAI program and an analysis of its effects, for nursing college students to learn emergency patient triage. This program was developed from November, 2000 to middle of September, 2001 with the aid of curriculum design experts. The subjects of this study were 86 randomly sampled freshmen students of C nursing college in Ulsan. They were divided into 45 for the test group and 41 for the control group. The CAI program for the learning of the emergency patient triage has been developed on the basis of Merrill's Component display theory and Keller's ARCS theory and through the curriculum design process of Hannafin & Peck. It has also been done with the use of Tool book 8.0, the multimedia righting tool. The experiment to verify the effect of the CAI program has been carried on from September, 20 to October, 8 2001. There were six hypotheses to accomplish the purpose of the study, and the analysis of the data was done with the use of SPSS/win program. As a result of this study, the author concluded that this CAI program is an effective mediation method to promote the learning accomplishment and learning motive for nursing college students. Therefore in the field of emergency nursing education, it would be possible to use this program as means for widening the possibility of self-learning and to promote individual learning of nursing college students.

Improvement Strategies of Arriving Time to the Scene by Enhancing EMTs' Recognition of Triage (구급출동지령서 개선을 통한 구급대원 현장 도착시간 단축방안)

  • Oh, Won Sin;Joung, Suck Hwan;Yoon, Myong Oh
    • Journal of the Korea Safety Management & Science
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    • v.17 no.1
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    • pp.45-52
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    • 2015
  • The purpose of this investigation is to enhance the survival rate of patients by transporting them to the hospital within the golden hour through the operational improvement of emergency dispatch instruction. To this end, problems and improvements of current operating system were derived by carrying out a survey against paramedics of Incheon city in 2012 and analyzing the current emergency dispatch instruction. This study analyzed the emergency activity daily reports for one year from January 1 through December 31, 2012 and researched the consciousness of 119 emergency medical technician. According to the analysis of the survey, there were no meaningful differences in the on-site arrival times per triage. Therefore, the item of 'Emergency Classification' specified in the emergency dispatch instruction needs to be integrated in the scheme of "triage". Also, the feedbacks of the emergency action log and the emergency dispatch instruction are necessary for 'duty for operation' to review the adequacy to the severity after the end of emergency operation. Finally, the improvement of the system for the continuous communication between the paramedics and the command staff is necessary. This improvements as stated above are expected to contribute to raise survival rate of patients.

Pediatric Dehydration Assessment at Triage: Prospective Study on Refilling Time

  • Caruggi, Samuele;Rossi, Martina;De Giacomo, Costantino;Luini, Chiara;Ruggiero, Nicola;Salvatoni, Alessandro;Salvatore, Silvia
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.278-288
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    • 2018
  • Purpose: Dehydration is a paediatric medical emergency but there is no single standard parameter to evaluate it at the emergency department. Our aim was to evaluate the reliability and validity of capillary refilling time as a triage parameter to assess dehydration in children. Methods: This was a prospective pilot cohort study of children who presented to two paediatric emergency departments in Italy, with symptoms of dehydration. Reliability was assessed by comparing the triage nurse's measurements with those obtained by the physician. Validity was demonstrated by using 6 parameters suggestive of dehydration. Comparison between refilling time (RT) and a validated Clinical Dehydration Score (CDS) was also considered. The scale's discriminative ability was evaluated for the outcome of starting intravenous rehydration therapy by using a receiver operating characteristic (ROC) curve. Results: Participants were 242 children. All nurses found easy to elicit the RT after being trained. Interobserver reliability was fair, with a Cohen's kappa of 0.56 (95% confidence interval [CI], 0.41 to 0.70). There was a significant correlation between RT and weight loss percentage (r-squared=-0.27; 95% CI, -0.47 to -0.04). The scale's discriminative ability yielded an area under the ROC curve (AUC) of 0.65 (95% CI, 0.57 to 0.73). We found a similarity between RT AUC and CDS-scale AUC matching the two ROC curves. Conclusion: The study showed that RT represents a fast and handy tool to recognize dehydrated children who need a prompt rehydration and may be introduced in the triage line-up.

A Study on the Triage and Statitical Data by the 5 Developmental Stages of the Children in Emergency Room, PNU (일 종합병원 응급실 내원아동의 Triage 및 발단단계별 통계적 고찰)

  • Kim Young Hae;Lee Hwa Ja;Cho Seok Ju
    • Child Health Nursing Research
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    • v.5 no.2
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    • pp.136-150
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    • 1999
  • The subjects, under 18 old, 2,694 children who visited ER during 1998, were surveyed by the Triage and other statitical data. The results were as follows 1. The male to female ratio was 1.7 : 1, and the toddler(1-4 old) was the majority. 2. Triage ; critical 1.3%, acute 14.6%, urgent 29.5%, nonemergent 54.6%. 3. The reasons of visiting ER ; 1) The children had diseases(46.5%), injury (36.9%), TA(5.6%) and toxication(1.0%). 2) In diseases, male to female ratio was 1.5 : 1 and in injury, male to female was 2 : 1. 3) Among the children having in TA, 12-18 old groups was the majority(34.9%). 4. The time of visiting : the 20:00 - 22:00 was the majority(16.9%). 5. By monthly and seasonal distribution ; Jan. (9.7%), Mar. and May(9% respectively, Dec. and July(6.7%) respectively. The children who visted ER in spring and autumn showed higher portion than those of summer and winter. 6. Results ; admission(27.4%), discharge(68.4%), operations(2.8%), and DOA and DAA(0.4%), The mortality of the infancy and toddler groups was 83.3%. The infancy group showed the highest rate of admission. 7. The time of staying in ER ; 1-2 hrs was the major group(23.3%) and the average was 4.6 hours. 8. By clinical departments ; Ped. was 34.4%, PS was 20.8%, Dental Surgery was 10.3% and Dermatology was 0.9%. 9. The types of visting ; the group who visited by themselves was 80%, transfer from the primary and secondary clinic was 17% and OPD was 3.0%. 10. The traffic means . by the own cars and taxi were 87.6%, by hospital ambulance was 6.1% and by 119 ambulance was 4.3%.

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Validation of the Simplified Motor Score for the Triage after Traumatic Brain Injury (두부 외상 환자의 중증도 평가 시 단순운동점수의 유용성)

  • Lee, Sang Kyong;Ryoo, Hyun Wook;Park, Jung Bae;Seo, Kang Suk;Chung, Jae Myung
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.71-77
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    • 2008
  • Purpose: The Glasgow Coma Scale (GCS), though it is widely used for triage, has been criticized as being unnecessarily complex. Recently, a 3-point Simplified Motor Score (SMS, defined as obeys commands=2; localizes pain=1; withdrawals to pain or worse=0) was developed from the motor component of the GCS and was found to have a similar test performance for triage after traumatic brain injury when compared with the GCS as the criterion standard. The purpose of this study was to validate the SMS. Methods: We analyzed the patients who visited Kyungpook National University Hospital emergency center after traumatic brain injury from 2006 January to 2006 June. The test performance of the GCS, its motor component, and SMS relative to three clinically relevant traumatic brain injury outcomes (abnormal brain CT scans, Abbreviated Injury Scale $(AIS){\geq}4$, and mortality) were evaluated with areas under the receiver operating characteristic curves (AUCs). Results: Of 504 patients included in the analysis, 25.6% had an abnormal brain CT scans, 13.1% had $AIS{\geq}4$, and 5.0% died. The AUCs for the GCS, its motor component, and SMS with respect to the abnormal CT scans were 0.776, 0.715, and 0.716, and respectively, those for $AIS{\geq}4$ and mortality, were 0.969, 0.973, and 0.968, and 0.931, 0.909, and 0.909, respectively. Conclusion: The 3-point SMS demonstrated similar test performance when compared with the 15-point GCS score and its motor component for triage after traumatic brain injury in our populations.

Systematic Review of Bug Report Processing Techniques to Improve Software Management Performance

  • Lee, Dong-Gun;Seo, Yeong-Seok
    • Journal of Information Processing Systems
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    • v.15 no.4
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    • pp.967-985
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    • 2019
  • Bug report processing is a key element of bug fixing in modern software maintenance. Bug reports are not processed immediately after submission and involve several processes such as bug report deduplication and bug report triage before bug fixing is initiated; however, this method of bug fixing is very inefficient because all these processes are performed manually. Software engineers have persistently highlighted the need to automate these processes, and as a result, many automation techniques have been proposed for bug report processing; however, the accuracy of the existing methods is not satisfactory. Therefore, this study focuses on surveying to improve the accuracy of existing techniques for bug report processing. Reviews of each method proposed in this study consist of a description, used techniques, experiments, and comparison results. The results of this study indicate that research in the field of bug deduplication still lacks and therefore requires numerous studies that integrate clustering and natural language processing. This study further indicates that although all studies in the field of triage are based on machine learning, results of studies on deep learning are still insufficient.

A Study on the Triage and Statitical Data of Patients in the Emergency Room, PNU (일 종합병원 응급실 이용환자의 중증도 분류)

  • 김영혜;이화자;조석주
    • Journal of Korean Academy of Nursing
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    • v.31 no.1
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    • pp.68-80
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    • 2001
  • The purpose of this study is to analyze ER patient's Triage and other statistical data. The subjects were 12,618 patients who visited the ER during the year 1998. The study showed the following results; 1. The male vs female ratio was 1.3 : 1.0, the male were in the majority (56.6%), and the age range of 20-29 old was the majority (15.3). The patients who visited ER at 8-10 pm were the majority (11.5%). On Sunday the number of patients who visited the ER were 2,189, and the majority were 17.4%. On Saturday the number of patients was visited the ER were 1,944 patients the second majority (15.4%). Their traffic means : the general passenger cars (75.5%), 119 or hospital ambulance (11.3%). 2.The reasons of visiting ER were : diseases (59.2%), injuries (23.7%). The disease vs injury ratio was 100 : 69. 3. Triage : urgent 40.7%, non-urgent 38.2%, acute 17.8%, and critical 3.2%. 4. The time of waiting and staying in the ER by the Triaget: the average time was 572 minutes (9.53 hrs.). The majority of critical patients (20.5%), acute patients (24.7%) and urgent patients (21.2%) stayed 12-24 hrs., but the majority of non-emergent (27.8%) stayed not longer than one hour. 5. Treatments by the Triage : the 42.9% of critical patients, and 61.3% of acute patients, 57.5% of urgent patients were admitted. But 91.8% of the non-emergents were discharged and 4.7% was admitted. Mortality of total ER visiter were 1.7%. DAA portion was 0.86%. 26.6% of the critical patients were DAA. DAA vs DOA ratio was 1.3 : 1.0. 6. Visiting time, monthly and seasonal distribution by the Triage : the majority of critical patients (12.2%), visited 10-12 am. The majority of acute (12.9%) and urgent (11.7%) visited 4-6 pm, but the majority of non-emergents (15.1%) visited during 8-10 pm. Autumn visiter were the majority (27.6%). The percentage of non-emergent visited in Spring was 41.4% and Autumn was 41.3%. The percentage of urgents who visited in the Summer was 45.3% and the Winter was 40.4%. By clinical departments: the 48.0% of critical patients was NS. The 45.5% of acute and the 33.6% of urgent patients were IM. But the majority of non-emergent patients was PS (21.2%), and the second majority of non-emergent patients was oral Surgery (12.8%).

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A Systematic Review on Studies Related to Disaster (재난관련 연구의 체계적 문헌고찰)

  • Park, Ju Young;Kim, Gaeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.276-292
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    • 2018
  • This study was conducted to investigate the trends in domestic and international disaster-related research through a systematic review of the literature and to establish a basis for future disaster-related countermeasures and development directions. A related literature search was conducted through the domestic and foreign databases through the combination of disaster-related terms from 2000 until February 28, 2017, and 79 articles were used in the analysis based on selection and exclusion criteria of 177 total documents. As a result of the research, 31.6% of disaster research type was quantitative studies, and 29.1% of the major disciplines were medical research. In addition, there were engineering(18.9%), public administration(13.9%), and nursing(11.4%). In foreign literature, there are many triage studies for the classification of patients in multiple lesions. On the other hand, only 30.4% of total triage studies in Korea were detected. Most of them were related to triage development, triage evaluation, triage research, and reviews. In addition, according to the disaster nursing capacity framework of the International Council of Nurses, 72.3% of studies were related to the response phase. Future research on disasters requires interdisciplinary convergence, patient classification, and technology integration to improve the survival rate of multiple injuries, and an integrated system based on the results of collaborative research among interdisciplinary groups is needed.

Performance of HPV DNA Testing with Hybrid Capture 2 in Triaging Women with Minor Cervical Cytologic Abnormalities (ASC-US/LSIL) in Northern Thailand

  • Khunamornpong, Surapan;Settakorn, Jongkolnee;Sukpan, Kornkanok;Srisomboon, Jatupol;Suprasert, Prapaporn;Siriaunkgul, Sumalee
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10961-10966
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    • 2015
  • Background: Minor cervical cytologic abnormalities include atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL). Approximately 10-20% of women with minor cytologic abnormalities have histologic high-grade squamous intraepithelial or worse lesions (HSIL+). In Thailand, women with minor cytologic abnormalities have a relatively high risk of cervical cancer, and referral for colposcopy has been suggested. A triage test is useful in the selection of women at risk for histologic HSIL+ to reduce the colposcopy burden. The aim of this study was to assess the performance of high-risk HPV DNA test in triage of women with minor cytologic abnormalities in northern Thailand. Materials and Methods: All women with ASC-US/LSIL cytology who were referred to our colposcopy clinic from October 2010 to February 2014 were included. HPV DNA testing was performed using Hybrid Capture 2 (HC2). All patients received colposcopic examination. Accuracy values of HC2 in predicting the presence of histologic HSIL+ were calculated. Results: There were 238 women in this study (121 ASC-US and 117 LSIL). The HC2 positivity rate was significantly higher in the LSIL group than in ASC-US group (74.8% versus 41.0%, p<0.001). Histologic HSIL+ was detected in 9 women (7.4%) in the ASC-US group and 16 women (13.7%) in the LSIL group (p=0.141). There was no histologic HSIL+ detected among HC2-negative cases (sensitivity and negative predictive value of 100%). The performance of HC2 triage was highest among women aged >50 years with ASC-US cytology. An increase in the cut-off threshold for positive HC2 resulted in a substantial decrease of sensitivity and negative predictive value. Conclusions: HPV DNA testing with HC2 shows very high sensitivity and negative predictive value in triage of women with minor cervical cytologic abnormalities in northern Thailand. An increase of the cut-off threshold for HC2 triage is not recommended in this region.

Evaluation of Validity of the Korean Triage and Acuity Scale (한국형 응급환자 분류도구의 타당도 평가)

  • Choi, Heejung;Ok, Jong Sun;An, Soo Young
    • Journal of Korean Academy of Nursing
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    • v.49 no.1
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    • pp.26-35
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    • 2019
  • Purpose: The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS). Methods: This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value. Results: In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively. Conclusion: The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.