Abstract
AimThe purpose of this study was to better understand the effects of introducing the Japan Triage and Acuity Scale (JTAS) in the emergency room for walk‐in patients.MethodsA simple triage was used in Term A (from April 2006 to December 2010, 4 years and 9 months) and the JTAS was introduced in Term B (from January 2011 to September 2015, 4 years and 9 months). The number of patients who had a sudden turn for the worse after arrival in the emergency room and the time between attendance and emergency catheterization (TBAEC) due to acute coronary syndrome were reviewed.ResultsThere were 653 patients in Term A and 626 patients in Term B who were finally diagnosed as having serious causes. There was no significant difference in the frequency of a sudden turn for the worse between the two terms. There were 182 patients in Term A and 167 patients in Term B who underwent emergency catheterization due to acute coronary syndrome. When ST elevation was recognized in the first electrocardiogram, the median time between attendance and medical attention during Term B improved significantly, by 4.5 min. However, there was no significant difference in medians for TBAEC. When ST elevation was not recognized, there was no significant difference between the two terms, neither in terms of median time between attendance and medical attention, nor TBAEC.ConclusionThe data suggests that the effects of introducing the JTAS in the emergency room were restrictive in these two aspects.
Highlights
A FTER THE INTRODUCTION and spread of USoriginated emergency medicine in Japan, doctors in some specific hospitals are required to treat patients with conditions of varying seriousness, so an adequate triage by nurses has become more important for walk-in patients in emergency rooms.[1,2,3] there are several triage systems by nurses in emergency rooms,[1,4] the Japanese Society for Emergency Medicine and the Japanese Association for Emergency Nursing are developing the Japan Triage and Acuity Scale (JTAS, see Appendix) as the standardized triage system in emergency departments.[5,6] Before the introduction of this kind of systematic triage system, simple triage systems were used in a lot of hospitals
After exclusion of patients who went home or were hospitalized to standard wards, 54 patients in Term A and six patients in Term B who were admitted to the intensive care unit (ICU) or stroke care unit (SCU) and might have been able to be treated at standard wards were excluded from the serious condition classification
When we decided that problems of triage possibly exist in patients where the waiting time was longer than 15 min and the sudden turn for the worse occurred in the waiting room or occurred within 30 min after the start of medical attention, there was one patient each in Term A and Term B, and there was no significant difference in the frequency of a sudden turn for the worse between the two terms
Summary
A FTER THE INTRODUCTION and spread of USoriginated emergency medicine in Japan, doctors in some specific hospitals are required to treat patients with conditions of varying seriousness, so an adequate triage by nurses has become more important for walk-in patients in emergency rooms.[1,2,3] there are several triage systems by nurses in emergency rooms,[1,4] the Japanese Society for Emergency Medicine and the Japanese Association for Emergency Nursing are developing the Japan Triage and Acuity Scale (JTAS, see Appendix) as the standardized triage system in emergency departments.[5,6] Before the introduction of this kind of systematic triage system, simple triage systems were used in a lot of hospitals. There are no studies comparing the effects before and after the introduction of the JTAS. Even though such serious patients fall into cardiopulmonary arrest just after arrival, problems of triage are not likely to occur as emergency care is immediately started
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