Introduction: the ‘5-point systems’ triage is routinely used in human emergency medicine. In veterinary medicine, the severity of the patients’ condition is often assessed with a rapid evaluation of major body systems. The objective of this study was to retrospectively evaluate the utility of a simplified canine ‘4-points triage system’ for veterinary nurses, in an Italian Veterinary Hospital. Methods: triage was performed by trained veterinary nurses using a modified 4 point triage (QTS-4). Signalment, reason for the visit, level of consciousness, breathing pattern, heart rate, mucous membrane color, refill time, pulse, SAP, MAP, and rectal temperature were recorded. A triage code modified on 4 points (red, yellow, green or white) was used. Time of triage and outcome were registered. Results: Thirty-nine dogs were enrolled. Thirty-six (92.3%) presented alert, 2 (5%) severely depressed and 1 moderately depressed. Eighteen dogs (46%) showed labored breathing or dyspnea, 21 (54%) normal breathing pattern. Mean heart rate was 132±43/min, mean SAP 161±39.6 mm Hg, mean MAP 110.2±31 mm Hg; capillary refill time was > 2 sec in 2 (5%) dogs, < 2 sec in 31 (79.4%), = 2 sec in 1 (2.5%) and not evaluated in 5 (13%). Median rectal temperature was 38.7°C (36-41°C). Four dogs (10%) showed weak or absent femoral pulses, 35 (89.7%) had good pulses. Thirty-one out of 39 (79%) survived. All ten dogs presenting as a white code (1 dermatological, 1 gastroenteric, 1 neurological, 4 orthopedics, 1 minor trauma, 2 cutaneous vegetal foreign body) survived. Fourteen dogs were classified as green code with a survival of 13/14. Ten were assigned a yellow code with a survival of 5/10. Five were classified as red code with a survival of 3/5. QTS-4 was completed in a median time of 5 minutes (range 3-10). Dogs with abnormal mentation were evaluated more rapidly with a QTS-4 time of less than 5 minutes. No association was found between code assigned and time needed to complete QTS-4 (Chi-square test; P = 0.49). A significant association was found between code assigned and survival (Chi-square test; P = 0.01). Conclusions: this score is associated with outcome and might be helpful following further validation, in identifying critically ill patients.
A QUICK FOUR-POINT TRIAGE SYSTEM (QTS-4) FORVETERINARY NURSES IN AN ITALIAN EMERGENCY HOSPITAL
Ceccherini G;Tulone F;Marchetti VUltimo
2021-01-01
Abstract
Introduction: the ‘5-point systems’ triage is routinely used in human emergency medicine. In veterinary medicine, the severity of the patients’ condition is often assessed with a rapid evaluation of major body systems. The objective of this study was to retrospectively evaluate the utility of a simplified canine ‘4-points triage system’ for veterinary nurses, in an Italian Veterinary Hospital. Methods: triage was performed by trained veterinary nurses using a modified 4 point triage (QTS-4). Signalment, reason for the visit, level of consciousness, breathing pattern, heart rate, mucous membrane color, refill time, pulse, SAP, MAP, and rectal temperature were recorded. A triage code modified on 4 points (red, yellow, green or white) was used. Time of triage and outcome were registered. Results: Thirty-nine dogs were enrolled. Thirty-six (92.3%) presented alert, 2 (5%) severely depressed and 1 moderately depressed. Eighteen dogs (46%) showed labored breathing or dyspnea, 21 (54%) normal breathing pattern. Mean heart rate was 132±43/min, mean SAP 161±39.6 mm Hg, mean MAP 110.2±31 mm Hg; capillary refill time was > 2 sec in 2 (5%) dogs, < 2 sec in 31 (79.4%), = 2 sec in 1 (2.5%) and not evaluated in 5 (13%). Median rectal temperature was 38.7°C (36-41°C). Four dogs (10%) showed weak or absent femoral pulses, 35 (89.7%) had good pulses. Thirty-one out of 39 (79%) survived. All ten dogs presenting as a white code (1 dermatological, 1 gastroenteric, 1 neurological, 4 orthopedics, 1 minor trauma, 2 cutaneous vegetal foreign body) survived. Fourteen dogs were classified as green code with a survival of 13/14. Ten were assigned a yellow code with a survival of 5/10. Five were classified as red code with a survival of 3/5. QTS-4 was completed in a median time of 5 minutes (range 3-10). Dogs with abnormal mentation were evaluated more rapidly with a QTS-4 time of less than 5 minutes. No association was found between code assigned and time needed to complete QTS-4 (Chi-square test; P = 0.49). A significant association was found between code assigned and survival (Chi-square test; P = 0.01). Conclusions: this score is associated with outcome and might be helpful following further validation, in identifying critically ill patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
