J Korean Med Sci.  2007 Apr;22(2):336-341. 10.3346/jkms.2007.22.2.336.

Triage Method for Out-of-Hospital Poisoned Patients

• Kwon WY
• Rhee JE
• Gang HS
• Shin SD
• Cho JH
• Song HG
• Suh GJ

• KMID: 1713197
• DOI: http://doi.org/10.3346/jkms.2007.22.2.336

Abstract

The aim of this study was to develop and evaluate a triage method to prevent unnecessary emergency department visits of out-of-hospital poisoned patients. From October 2003 to September 2004, the calls that lay persons gave to the Seoul Emergency Medical Information Center to seek advices on the out-of-hospital poisoned patients were enrolled. We designed a triage protocol that consisted of five factors and applied it to the patients. According to the medical outcomes, we classified the patients into two groups, the toxicity-positive and the toxicity-negative. We arranged the factors on the basis of the priority that was determined in order of the odds ratio of each factor for the toxicity-positive and made a flow chart as a triage method. Then we calculated a sensitivity, specificity, positive predictive value and negative predictive value of the method. We regarded the specificity as the ability of the method and the sensitivity as the safety. A total of 220 patients were enrolled in this study. The method showed a sensitivity, specificity, positive predictive value, and negative predictive value of 99.2%, 53.4%, 76.2%, and 97.9%, respectively. Our triage method prevented 53.4% of the unnecessary emergency department visits of outof-hospital acutely poisoned patients, safely.

Keyword

Triage; Poisoning

MeSH Terms

Triage/methods/*organization & administration
Telephone
Telemedicine/methods/*organization & administration
Severity of Illness Index
Sensitivity and Specificity
Risk Factors
Risk Assessment/*methods
Reproducibility of Results
Prognosis
Poisoning/*diagnosis/*therapy
Male
Korea
Humans
Female
Emergency Medical Services/methods/*organization & administration
Decision Trees
*Decision Support Techniques
Child, Preschool
Child
Adult
Adolescent

Figure

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  Fig. 1 Triage Protocol. *Examples of minimally toxic substances approved by the AAPCC panel (3), †Clinical effects captured by TESS data (10), ‡Individual patient circumstances (3), §Social environment (3).

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  Fig. 2 Flow chart as triage method. *Statistically do not increase the likelihood of the toxicity-positive.

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