OCULAR EMERGENCY TRIAGE OF EMERGENCY DEPARTMENT IN A REGIONAL HOSPITAL

區域醫院急診部對眼科急診之檢傷分類

譚超毅(Chau-Yi Tan) ； 楊博閔(Po-Min Yang) ； 蔡忠斌(Chong-Bin Tsai)

《中華民國眼科醫學會雜誌》 55卷 (2016/12) Pp. 31-35

https://doi.org/10.30048/ACTASOS.201612_55.0005

摘要

Purpose: To evaluate the accuracy of ocular emergency triage in an emergency department (ED) in a regional hospital. Method: This retrospective study reviewed the electronic medical records of patients presented to ocular emergency service from Jan. 1 to Jun. 30, 2013. Patients were triaged by the ED duty triage nurses using 5-level Taiwan Triage and Acuity Scale (TTAS) on the spot and were classified into severe and non-severe groups by a senior ophthalmologist based on disease severity afterward. Result: Among 703 enrolled patients, 0%, 11.81%, 84.36%, 3.41% and 0.42% were assigned to TTAS levels 1, 2, 3, 4, and 5, respectively. Severe/non-severe patient numbers were 168/535. Percentage of severity was 56.62%, 19.73%, 16.67% and 0% in levels 2, 3, 4, and 5, respectively. Conclusion: TTAS, developed for general ED patients and not eyededicated, is not an appropriate triage system for ocular emergency patients. To develop a simple & easy-to-use ophthalmic coding system for our ED personnel may be beneficial.

關鍵字

ophthalmology ； emergency ； triage

並列摘要

目的：評估區域醫院急診部對眼科急診病患檢傷分類之準確度。方法：本回溯性病案研究對象為2013年1月至6月間至本院眼科急診就診之病患。急診檢傷護理師當下依據台灣急診檢傷與急迫度分級量表(TTAS)進行檢傷分類並通知值班眼科醫師處置。其後由資深眼科醫師依疾病嚴重度分成嚴重與非嚴重兩組以與檢傷分類結果比較。結果：納入研究之703位眼科急診病患，依TTAS分級於各級之比率為：第一級：0%、第二級：11.81%、第三級：84.36%、第四級：3.41%、第五級：0.42%。疾病嚴重度: 嚴重與非嚴重兩組人數各為168人與535人。嚴重組之病患於TTAS各級之比率為：第二級：56.62%、第三級：19.73%、第四級：16.67%、第五級：0%。結論：TTAS發展之標的為一般急診病患，而非針對眼科設計，對眼科急診病患而言並非適當的分級系統。如能發展一套簡單易用的眼科分級系統供急診人員運用應有助益。