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Triage and mortality
This is one of a range of studies we have published in the EMJ regarding the performance of emergency department (ED) triage scores. In this study, the researchers found that a quick ‘eyeball triage’ performed better at predicting mortality than the more formalised (and researched) Danish Emergency Priority Tool (DEPT). At first glance, this might suggest that rapid triage by relatively less qualified staff is ‘better’ than formalised triage, but we need to be cautious, very cautious about such conclusions. When we look at triage tools, we should assess them on what they are designed to do. DEPT was not designed to predict mortality, but rather the need for urgent intervention which is only loosely associated. Whether eyeball triage has a place is our departments remains an interesting question, but first we should define what we want it and its comparators to do.
Juicing, squeezing and returns of redirection
All UK and I suspect that all international emergency physicians will have suffered and been angered by arguments that most patients can be treated in alternative locations. While we all agree that some patients can be redirected, there are disagreements about the proportion and range that can be safely seen elsewhere. It often feels that the redirection bandwagon is led by politically and arguably discriminatory policy. …