Emergency Triage
CMAJ 1997;157:570
© Canadian Medical Association
Manchester Triage Group. Edited by Kevin Mackway-Jones. 156 pp. Illust. BMJ Publishing Group, London. 1996. Distributed in Canada by the Canadian Medical Association, Ottawa. $41.95 ($34.95 CMA members). ISBN 0-7279-1126-0
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Overall rating: |
Good |
Strengths: |
Indexed flow charts, introductory chapters, clear definitions |
Weaknesses: |
None |
Audience: |
Nursing, medical or other staff involved in the triage role |
This book, written by a group of physicians and nurses involved in emergency medicine, is designed to assist in the development of uniform guidelines for triage in emergency departments. It uses a 5-level classification system, with suggested time frames for patient assessment in each class. The initial chapters review basic definitions, the decision-making process, pain assessment and its role in triage, and management of specific types of patients, where individual characteristics may alter triage decisions (e.g., extremes of age, aggressiveness).
The bulk of the text contains flow charts that deal with chief complaints. Each topic is presented in a diagram, followed by notes and specific discriminators. There are charts for isolated topics (e.g., back pain, headache) and charts dealing with major incidents involving a number of patients simultaneously. The book concludes with basic definitions of all terms.
The introductory chapters are well written, and the flow charts are easy to follow. The chapter on pain assessment is especially useful because this is an area often ignored when establishing priorities, yet it is one of the most important factors from the perspective of the patient and family. The flow charts are not designed to be read as text; they are too repetitious. However, with their indexes they are ideal for reference.
While primarily designed for emergency departments, this volume could be used in walk-in clinics or urgent-care centres to help determine which individuals would be better served in another type of facility. It would also be useful as a teaching tool for house staff taking calls in the family medicine setting.
Lynne A. Fulton, BA, MD
Department of Emergency Services
Sunnybrook Health Science Centre
North York, Ont.
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