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How good is triage, and what is it good for?
  1. Kirsty Challen
  1. Emergency Department, Lancashire Teaching Hospitals NHS Trust, Sharoe Green Lane, Preston, UK
  1. Correspondence to Dr Kirsty Challen, School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; kirsty.challen{at}lthtr.nhs.uk

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Two papers in this month’s issue of EMJ systematically examine the validity of triage systems for adults and children1, while Tsai et al analyse the performance of prehospital triage criteria in Taiwan.2 Few emergency physicians have the luxury of being able to see all patients immediately and thus not needing triage.

Firstly, before we can find a good triage system, we need to consider why we triage. The underlying principle of triage is a utilitarian ethic of maximising the overall good, originally described in the military setting: ‘those who are dangerously wounded should receive the first attention, without regard to rank or distinction’.3 It presupposes that the patient with an ankle sprain does not benefit from waiting while the patient with ST elevation myocardial infarction (STEMI) is seen before him, but the population as a whole …

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