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An early warning? Universal risk scoring in emergency medicine
  1. Damian Roland,
  2. Timothy J Coats
  1. Leicester University, Leicester, UK
  1. Correspondence to Dr Damian Roland, Emergency Medicine Academic Group, Room 003A, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK; dr98{at}le.ac.uk

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The concept of triage is well established in emergency medicine. Originating in the Napoleonic wars it has been used internationally to determine the clinical need of patients presenting to emergency departments (ED). Triage systems have typically relied on the use of experienced staff or decision support systems to judge the time a patient can afford to wait before treatment commences. There are various triage models in place, but all follow this same principle and can be applied to both adults and children.

Despite being well established in emergency medicine the concept of ‘triage’ has only recently been adopted on hospital wards. It had become increasingly recognised that patients who deteriorated in hospital, especially those who subsequently died or were admitted to intensive care, demonstrated measurable physiological changes hours before recognition by medical and nursing staff.1 This led to the development of ‘early warning scores’ (a form of ward triage system), which have proliferated from their initial inception …

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