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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Reverse triage: more than just another method.

Gwen Pollaris1, Marc Sabbe

  • 1Department of Emergency Medicine, University Hospitals Leuven, Leuven, Belgium.

European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine
|October 20, 2015
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Summary

Reverse triage rapidly increases hospital surge capacity by identifying patients for early discharge. This strategy can alleviate Emergency Department crowding but requires careful consideration of potential negative consequences for patients.

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Area of Science:

  • Healthcare Management
  • Hospital Operations
  • Emergency Medicine

Background:

  • Emergency Department (ED) crowding is a significant challenge in healthcare systems.
  • Inpatient surge capacity is crucial for managing patient influx during emergencies.
  • Reverse triage offers a potential solution to optimize bed availability.

Purpose of the Study:

  • To systematically review the literature on reverse triage strategies.
  • To assess the effectiveness of reverse triage in creating inpatient surge capacity.
  • To identify potential benefits and drawbacks of early inpatient discharge.

Main Methods:

  • Conducted comprehensive electronic searches of multiple databases (MEDLINE, TRIP, Cochrane Library, CINAHL, EMBASE, Web of Science, SCOPUS) from 2004 to 2014.
  • Screened reference lists of relevant articles for additional studies.
  • Synthesized findings from identified publications on reverse triage.

Main Results:

  • Reverse triage can make 10-20% of hospital bed capacity available within hours.
  • It prioritizes Emergency Department patients with urgent needs over stable inpatients.
  • Early discharge may lead to negative consequences, including readmissions.

Conclusions:

  • Reverse triage is a novel approach to enhance hospital surge capacity and address ED crowding.
  • Further research is needed to fully understand its impact and optimize its implementation.
  • Careful patient selection is essential to mitigate risks associated with early discharge.