Emergency Medical Services Triage Using the Emergency Severity Index: Is it Reliable and Valid?

摘要: Introduction Efficient communication between emergency medical services (EMS) and ED providers using a common triage system may enable more effective transfers when EMS arrives in the department. We sought (1) to evaluate inter-rater reliability Emergency Severity Index (ESI) assignments designated by personnel nurses (registered [RNs]) (2) validity of ESI instrument. Methods This prospective, observational study evaluated scores assigned prehospital RNs. were trained use same methods used for nurse training. patients independent RN. Inter-rater reliability, differences based on provider experience, (sensitivity specificity) evaluated. Results Seventy-five paired, blinded triages completed. Overall concordance RNs was 0.409 (95% confidence interval [CI], 0.256-0.562). Agreement with less experience 0.519 CI, 0.258-0.780), whereas those 0.348 0.160-0.536; χ 2 = 1.413, df 1, P .235). Sensitivity ranged from 0% 67.86%. Specificity 68.09% 97.26%. Conclusions observed moderate RN assignments. sensitivity correct acuity assignment generally poor, specificity correctly not assigning particular level better. Additional research investigating potential causes poor agreement that we is warranted.