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Evaluation of a veterinary triage list modified from a human five-point triage system in 485 dogs and cats


Ruys, Laura J; Gunning, Myrna; Teske, Erik; Robben, Joris H; Sigrist, Nadja (2012). Evaluation of a veterinary triage list modified from a human five-point triage system in 485 dogs and cats. Journal of Veterinary Emergency and Critical Care, 22(3):303-312.

Abstract

OBJECTIVES: To devise a veterinary triage list (VTL) and to determine whether the application of this VTL results in more accurate categorization of emergency patients compared with intuitive triage.
DESIGN: Prospective and retrospective observational study.
SETTING: Private veterinary emergency clinic.
ANIMALS: Four hundred and eighty-five client-owned dogs and cats.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: A VTL was composed using a human triage system and data from medical records of the study group. Target waiting times were prospectively determined using intuition by veterinary nurses (TWT-N).  Target waiting times were subsequently determined retrospectively by the use of the VTL (TWT-VTL).  Both TWT-N and TWT-VTL were compared against target waiting times determined by a review team (TWT-R), which was considered the gold standard. TWT categories included 0, 15, 30-60, and 120 minutes, and were associated with triage categories red, orange, yellow, and green, respectively. Differences in agreement were tested for significance. One hundred and eighty-five dogs and 300 cats fulfilled the inclusion criteria. TWT-N and TWT-R agreed on 30 cases of 67 (44.8%) in triage category red and 22 of 89 (24.7%) in category orange. TWT-VTL and TWT-R agreed on 64 cases of 67 (95.5%) in category red and 75 of 89 (84.3%) in category orange. Agreement between TWT-VTL and TWT-R (Pearson's R = 0.848) was significantly greater (P < 0.001) than agreement between TWT-N and TWT-R (Pearson's R = 0.519).
CONCLUSIONS: Intuitive triage performed by veterinary nurses showed significantly less correlation with TWT-R than triage performed with the VTL. A short physical examination in all emergency patients appears to be essential in recognizing critical disease. The use of a standardized VTL can help to categorize veterinary emergency patients.

Abstract

OBJECTIVES: To devise a veterinary triage list (VTL) and to determine whether the application of this VTL results in more accurate categorization of emergency patients compared with intuitive triage.
DESIGN: Prospective and retrospective observational study.
SETTING: Private veterinary emergency clinic.
ANIMALS: Four hundred and eighty-five client-owned dogs and cats.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: A VTL was composed using a human triage system and data from medical records of the study group. Target waiting times were prospectively determined using intuition by veterinary nurses (TWT-N).  Target waiting times were subsequently determined retrospectively by the use of the VTL (TWT-VTL).  Both TWT-N and TWT-VTL were compared against target waiting times determined by a review team (TWT-R), which was considered the gold standard. TWT categories included 0, 15, 30-60, and 120 minutes, and were associated with triage categories red, orange, yellow, and green, respectively. Differences in agreement were tested for significance. One hundred and eighty-five dogs and 300 cats fulfilled the inclusion criteria. TWT-N and TWT-R agreed on 30 cases of 67 (44.8%) in triage category red and 22 of 89 (24.7%) in category orange. TWT-VTL and TWT-R agreed on 64 cases of 67 (95.5%) in category red and 75 of 89 (84.3%) in category orange. Agreement between TWT-VTL and TWT-R (Pearson's R = 0.848) was significantly greater (P < 0.001) than agreement between TWT-N and TWT-R (Pearson's R = 0.519).
CONCLUSIONS: Intuitive triage performed by veterinary nurses showed significantly less correlation with TWT-R than triage performed with the VTL. A short physical examination in all emergency patients appears to be essential in recognizing critical disease. The use of a standardized VTL can help to categorize veterinary emergency patients.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Department of Small Animals
Dewey Decimal Classification:570 Life sciences; biology
630 Agriculture
Date:June 2012
Deposited On:22 Mar 2016 12:45
Last Modified:08 Dec 2017 19:18
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1476-4431
Publisher DOI:https://doi.org/10.1111/j.1476-4431.2012.00736.x
PubMed ID:22702436

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