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Evaluation of a veterinary triage list modified from a human five-point triage system in 485 dogs and cats
Laura J Ruys1, Myrna Gunning, Erik Teske
1Medisch Centrum voor Dieren, Isolatorweg 45, 1014 AS, Amsterdam, The Netherlands. lauraruys@gmail.com
Objectives:
To devise a veterinary triage list (VTL) and to determine whether the application of this VTL results in more accurate categorization of emergency patients compared with intuitive triage.
Design:
Prospective and retrospective observational study.
Setting:
Private veterinary emergency clinic.
Animals:
Four hundred and eighty-five client-owned dogs and cats.
Interventions:
None.
Measurements And Main Results:
A VTL was composed using a human triage system and data from medical records of the study group. Target waiting times were prospectively determined using intuition by veterinary nurses (TWT-N). Target waiting times were subsequently determined retrospectively by the use of the VTL (TWT-VTL). Both TWT-N and TWT-VTL were compared against target waiting times determined by a review team (TWT-R), which was considered the gold standard. TWT categories included 0, 15, 30-60, and 120 minutes, and were associated with triage categories red, orange, yellow, and green, respectively. Differences in agreement were tested for significance. One hundred and eighty-five dogs and 300 cats fulfilled the inclusion criteria. TWT-N and TWT-R agreed on 30 cases of 67 (44.8%) in triage category red and 22 of 89 (24.7%) in category orange. TWT-VTL and TWT-R agreed on 64 cases of 67 (95.5%) in category red and 75 of 89 (84.3%) in category orange. Agreement between TWT-VTL and TWT-R (Pearson's R = 0.848) was significantly greater (P < 0.001) than agreement between TWT-N and TWT-R (Pearson's R = 0.519).
Conclusions:
Intuitive triage performed by veterinary nurses showed significantly less correlation with TWT-R than triage performed with the VTL. A short physical examination in all emergency patients appears to be essential in recognizing critical disease. The use of a standardized VTL can help to categorize veterinary emergency patients.
