Emergency medicine journal : EMJ
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Observational Study
Validation of the five-tier Taiwan Triage and Acuity Scale for prehospital use by Emergency Medical Technicians.
This study aimed to determine the inter-rater reliability of the five-level Taiwan Triage and Acuity Scale (TTAS) when used by emergency medical technicians (EMTs) and triage registered nurses (TRNs). Furthermore, it sought to validate the prehospital TTAS scores according to ED hospitalisation rates and medical resource consumption. ⋯ A five-level prehospital triage scale shows good inter-rater reliability and superior discrimination compared with the two-level system for prediction of hospitalisation and medical resource requirements.
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For the London Olympic and Paralympic Games in 2012, a sentinel ED syndromic surveillance system was established to enhance public health surveillance by obtaining data from a selected network of EDs, focusing on London. In 2017, a new national standard Emergency Care Dataset was introduced, which enabled Public Health England (PHE) to initiate the expansion of their sentinel system to national coverage. Prior to this initiative, we estimated the added value, and potential additional resource use, of an expansion of the sentinel surveillance system. ⋯ We have quantified the added value of national ED syndromic surveillance systems, showing how they will enable detection of more localised events. Furthermore, national systems add value in enabling timelier public health interventions. Finally, we have highlighted areas where extra resource may be required to manage improvements in detection coverage.
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Recent terror attacks and assassinations involving highly toxic chemical weapons have stressed the importance of sufficient respiratory protection of medical first responders and receivers. As full-face respirators cause perceptual-motor impairment, they not only impair vision but also significantly reduce speech intelligibility. The recent introduction of electronic voice projection units (VPUs), attached to a respirator, may improve communication while wearing personal respiratory protection. ⋯ We found that the Avon C50 is the preferred model among the tested respirators. In our model, electronic voice projection modules improved loudness but not speech intelligibility. The Respirex PRPS NHS-suit was rated significantly less favourably in respect of medical communication and speech intelligibility.
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A shortcut review of the literature was carried out to examine the association of sexual dysfunction in the context of new-onset low back pain, with cauda equina syndrome (CES). Five papers were identified as suitable for inclusion using the reported search strategy. ⋯ It is concluded that clinicians appear to be poor at recording this feature during assessment, but between 12% and 96%, patients with confirmed CES will report the presence of new-onset sexual dysfunction at presentation when asked. It appears that this can also be a single isolated red flag feature in the context of low back pain and as such should be a mandatory part of any clinical assessment that seeks to evaluate the risk of impending CES.