JACEP
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The effectiveness of patient triage by a specially trained registered nurse in the emergency department of an urban county hospital, San Francisco General Hospital, was evaluated over a three-month period. Ambulatory patients thought to have nonemergent illnesses were directed to the Walk-In Service for physician evaluation and treatment; the remainder were seen in the Emergency Service. In three months, 11,329 patients registered for care, and 4,150 (37%) were referred to the Walk-In Service. ⋯ There were no deaths. Error in triage was about equally divided between mistaken diagnosis and underestimated severity of illnes. The overall accuracy of triage was 98%.
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In 23 patients with laryngotracheal trauma at the Louisville General Hospital during a ten-year period, 19 survived. One death was directly atributable to the airway injury. The most common postinjury complication was hoarsensess attributable to direct injury to the cords or recurrent nerve paralysis. ⋯ Appropriate endoscopy and radiographic studies should confirm the diagnosis. Control of the airway is achieved by emergency tracheostomy or intubation followed by tracheostomy. Prompt operative intervention and primary repair follow.
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At Brooke Army Medical Center the Emergency Services Section has developed an algorith,-directed triage system to be used by "screeners" who may be basic medical corpsmen but sometimes have had no previous medical experience. After 25 hours of classroom and 120 hours of on-the-job training, the screeners use the algorithms to triage patients into one of three treatment areas in the emergency section or to clinics outside the emergency section during the day and evening. The screeners may consult with a triage physician if the algorithm-directed disposition appears inappropriate, Triage dispositions of 78,822 patient visits during the calendar year 1975 are presented.