A matched-cohort study of pediatric head injuries: collecting data to inform an evidence-based triage assessment.

Unlabelled: Triage nurses are the "first stop" for patients who present to the emergency department for care. The assessment of pediatric head injuries is especially challenging because signs and symptoms of head trauma in children do not correlate well with the risk of closed head injury (CHI).

Methods: A retrospective matched cohort study was conducted to compare 2 groups of patients who presented to a pediatric emergency department for evaluation of a head injury: a CHI-positive cohort and a CHI-negative cohort as identified by computed tomography scan.

Reliability and validity of the emergency severity index for pediatric triage.

Objectives: The Emergency Severity Index (ESI) triage algorithm is a five-level triage acuity tool used by emergency department (ED) triage nurses to rate patients from Level 1 (most acute) to Level 5 (least acute). ESI has established reliability and validity in an all-age population, but has not been well studied for pediatric triage. This study assessed the reliability and validity of the ESI for pediatric triage at five sites.

Defining and applying a method for improving the sensitivity and specificity of an emergency department early event detection system.

The sensitivity and specificity of syndrome definitions used in early event detection (EED) systems affect the usefulness of the system for end-users. The ability to calculate these values aids system designers in the refinement of syndrome definitions to better meet public health needs. Utilizing a stratified sampling method and expert review to create a gold standard dataset for the calculation of sensitivity and specificity, we describe how varying syndrome structure impacts these statistical parameters and discuss the relevance of this to outbreak detection and investigation.

Unified medical language system coverage of emergency-medicine chief complaints.

Background: Emergency department (ED) chief-complaint (CC) data increasingly are important for clinical-care and secondary uses such as syndromic surveillance. There is no widely used ED CC vocabulary, but experts have suggested evaluation of existing health-care vocabularies for ED CC.

Objectives: To evaluate the ED CC coverage in existing biomedical vocabularies from the Unified Medical Language System (UMLS).

Evaluation of emergency medical text processor, a system for cleaning chief complaint text data.

Objectives: Emergency Medical Text Processor (EMT-P) version 1, a natural language processing system that cleans emergency department text (e.g., chst pn, chest pai), was developed to maximize extraction of standard terms (e.

Emergency Department data for bioterrorism surveillance: electronic data availability, timeliness, sources and standards.

Emergency Department (ED) data are a key component of bioterrorism surveillance systems. Little research has been done to examine differences in ED data capture and entry across hospitals, regions and states. The purpose of this study was to describe the current state of ED data for use in bioterrorism surveillance in 2 regions of the country.

Diagnosis clusters for emergency medicine.

Objectives: Aggregated emergency department (ED) data are useful for research, ED operations, and public health surveillance. Diagnosis data are widely available as The International Classification of Diseases, version, 9, Clinical Modification (ICD-9-CM) codes; however, there are over 24,000 ICD-9-CM code-descriptor pairs. Standardized groupings (clusters) of ICD-9-CM codes have been developed by other disciplines, including family medicine (FM), internal medicine (IM), inpatient care (Agency for Healthcare Research and Quality [AHRQ]), and vital statistics (NCHS).

Using nurses' natural language entries to build a concept-oriented terminology for patients' chief complaints in the emergency department.

Information about the chief complaint (CC), also known as the patient's reason for seeking emergency care, is critical for patient prioritization for treatment and determination of patient flow through the emergency department (ED). Triage nurses document the CC at the start of the ED visit, and the data are increasingly available in electronic form. Despite the clinical and operational significance of the CC to the ED, there is no standard CC terminology.

The emergency severity index triage algorithm version 2 is reliable and valid.

Objectives: Initial studies have shown improved reliability and validity of a new triage tool, the Emergency Severity Index (ESI), over conventional three-level scales at two university medical centers. After pilot implementation and validation, the ESI was revised to include pediatric and updated vital signs criteria. The goal of this study was to assess ESI version (v.

Five-level triage system more effective than three-level in tertiary emergency department.

Introduction: The study objectives were to compare reliability and validity of a 3-level (3L) triage system with a new 5-level (5L) triage system and determine the effect of nursing experience on triage reliability.

Methods: The study was conducted in a southeastern tertiary emergency department. With a stratified random sample, reliability of 3L triage ratings was measured with weighted kappa (time 1).