Kwon Woon Yong, Rhee Joong Eui, Gang Hong Seong, Shin Sang Do, Cho Jun Hwi, Song Hyoung Gon, Suh Gil Joon
Department of Emergency Medicine, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul, Korea.
J Korean Med Sci. 2007 Apr;22(2):336-41. doi: 10.3346/jkms.2007.22.2.336.
The aim of this study was to develop and evaluate a triage method to prevent unnecessary emergency department visits of out-of-hospital poisoned patients. From October 2003 to September 2004, the calls that lay persons gave to the Seoul Emergency Medical Information Center to seek advice on the out-of-hospital poisoned patients were enrolled. We designed a triage protocol that consisted of five factors and applied it to the patients. According to the medical outcomes, we classified the patients into two groups, the toxicity-positive and the toxicity-negative. We arranged the factors on the basis of the priority that was determined in order of the odds ratio of each factor for the toxicity-positive and made a flow chart as a triage method. Then we calculated a sensitivity, specificity, positive predictive value and negative predictive value of the method. We regarded the specificity as the ability of the method and the sensitivity as the safety. A total of 220 patients were enrolled in this study. The method showed a sensitivity, specificity, positive predictive value, and negative predictive value of 99.2%, 53.4%, 76.2%, and 97.9%, respectively. Our triage method prevented 53.4% of the unnecessary emergency department visits of out-of-hospital acutely poisoned patients, safely.
本研究的目的是开发并评估一种分诊方法，以防止院外中毒患者不必要的急诊科就诊。2003年10月至2004年9月，纳入了非专业人员致电首尔紧急医疗信息中心咨询院外中毒患者的电话。我们设计了一个由五个因素组成的分诊方案，并将其应用于患者。根据医疗结果，我们将患者分为两组，即毒性阳性组和毒性阴性组。我们根据每个因素对毒性阳性的优势比确定的优先级来安排这些因素，并制作了一个流程图作为分诊方法。然后我们计算了该方法的灵敏度、特异度、阳性预测值和阴性预测值。我们将特异度视为该方法的能力，将灵敏度视为安全性。本研究共纳入220例患者。该方法的灵敏度、特异度、阳性预测值和阴性预测值分别为99.2%、53.4%、76.2%和97.9%。我们的分诊方法安全地防止了53.4%的院外急性中毒患者不必要的急诊科就诊。
