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Editor's choice: Nurse versus computer for paediatric triage
This month, Takahashi et al present a retrospective cohort study evaluating the impact of allowing nurses to change the triage priority assigned by the computerised Japanese Triage and Acuity algorithm (JTAS), which is based on the patient's presenting complaint, historical factors and physiological parameters. In particular, the nurses could assign a lower triage category if they felt that the triage category was inappropriately high based on physiological parameters recorded when a child is distressed or looks otherwise well. The re-categorised triage priorities more appropriately predicted the need for hospital admission. This study presents early evidence to suggest that the ‘gestalt’ of experienced triage nurses could be used to avoid over-treatment and it provides an excellent platform for future work that is designed to evaluate safety outcomes.
Head injury: after the ‘golden hour’ come the danger hours?
It might seem reassuring when patients present late after a head injury. If a patient is going to have an intracranial haemorrhage, in usual circumstances we expect it to become …