[Triage in emergency departments. Comparative evaluation of 4 international triage systems]

Abstract

Background: Facing increasing pressure emergency departments have to replace the previously unstructured approach used to document incoming patients by a standardized quick method, which allows easy documentation of the results.

Objectives: The article describes the initial situation in international comparison and compares the available systems. The aim is to answer the following questions: what aspects should be taken into consideration when choosing a system, and what impact does this have on the selection of a system.

Materials and methods: Starting with the reflection of preliminary thoughts from Hamburg in 2000 regarding system decision-making, these considerations will be supplemented by the latest developments. The legal and factual backgrounds are represented in international comparison and from this the consequences for Germany are derived. Included are the most common five-tier systems Australasian Triage Scale, Canadian Triage and Acuity Scale, Emergency Severity Index and the Manchester Triage System. The systems are summarized and their strengths and weaknesses highlighted.

Results and conclusions: In the current situation and circumstances in German emergency departments best usability and maximum safety seems to be promised by the Manchester Triage System. Legal and structural requirements are taken into consideration by this system. Of particular advantage of the system is the international and national networking, which enables the integration of international developments and experience.

Keywords: Algorithm; Decision aids; Emergency medical services; International perspectives; Legal aspects.