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The proposed research study will be a prospective observational study designed to validate the Canadian Triage Assessment Scale (CTAS) in regard to work of breathing in patients in the emergency department. The investigators will assess inter-rater agreement between nurses & emergency physicians for assessment of work of breathing.
Investigators will enroll a convenience sample of consenting patients who present to the emergency department with a chief complaint related to respiratory symptoms, including shortness of breath, cough, difficulty breathing, hypoxemia, or any other respiratory related complaint.
Following consent and in a blinded fashion, the nurse & emergency physician will be asked to evaluate the patient's work of breathing into three subjective categories: mild, moderate, or severe. The two evaluators will not be aware of the others evaluation of the patient. Evaluators will also be asked to predict the patients likely need for intervention & disposition.
Subsequently, investigators will perform a chart review to determine the patient's clinical interventions, outcomes, and dispositions, and evaluate the assessment of the patients work of breathing.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with Respiratory Symptoms | The Canadian Triage Assessment Scale (CTAS) will be assessed via patient survey form and electronic chart review. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Canadian Triage Assessment Scale (CTAS) | Other | The CTAS incorporates work of breathing into a subjective measurement in its assessment of patients and triaged. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Inter-rater agreement between nurses and emergency physicians for the respiratory component of the Canadian Assessment Scale (CTAS) | The CTAS is utilized to qualitatively define work of breathing as severe, moderate, or mild. Kappa will be calculated to assess inter-rater reliability | 24 months |
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Inclusion Criteria:
Exclusion Criteria:
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Study subjects include any adult patients who present to the emergency department at Christus Spohn Hospital - Shoreline
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| Name | Affiliation | Role |
|---|---|---|
| Christopher Durand, DO | CHRISTUS Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHRISTUS Spohn Hospital | Corpus Christi | Texas | 78405 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Rui P, Kang K, Albert M. National Hospital Ambulatory Medical Care Survey: 2013 Emergency Department Summary Tables. Available from: http://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2013_ed_web_tables.pdf. | ||
| 28320369 | Background | Hutchinson A, Pickering A, Williams P, Bland JM, Johnson MJ. Breathlessness and presentation to the emergency department: a survey and clinical record review. BMC Pulm Med. 2017 Mar 20;17(1):53. doi: 10.1186/s12890-017-0396-4. | |
| 17378961 |
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The Principal Investigator may want to pursue other opportunities with collaborators and sponsors.
24 months
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| ID | Term |
|---|---|
| D004417 | Dyspnea |
| D012818 | Signs and Symptoms, Respiratory |
| D003371 | Cough |
| D000860 | Hypoxia |
| D004630 | Emergencies |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Background |
| Murray M, Bullard M, Grafstein E; CTAS Natioanal Working Group; CEDIS National Working Group. Revisions to the Canadian Emergency Department Triage and Acuity Scale implementation guidelines. CJEM. 2004 Nov;6(6):421-7. No abstract available. |
| 22831826 | Background | Horeczko T, Enriquez B, McGrath NE, Gausche-Hill M, Lewis RJ. The Pediatric Assessment Triangle: accuracy of its application by nurses in the triage of children. J Emerg Nurs. 2013 Mar;39(2):182-9. doi: 10.1016/j.jen.2011.12.020. Epub 2012 Jul 24. |
| 17466139 | Background | Jimenez JG, Murray MJ, Beveridge R, Pons JP, Cortes EA, Garrigos JB, Ferre MB. Implementation of the Canadian Emergency Department Triage and Acuity Scale (CTAS) in the Principality of Andorra: Can triage parameters serve as emergency department quality indicators? CJEM. 2003 Sep;5(5):315-22. |
| 26251308 | Background | Alquraini M, Awad E, Hijazi R. Reliability of Canadian Emergency Department Triage and Acuity Scale (CTAS) in Saudi Arabia. Int J Emerg Med. 2015 Dec;8(1):80. doi: 10.1186/s12245-015-0080-5. Epub 2015 Aug 7. |
| 28416251 | Background | Paniagua N, Elosegi A, Duo I, Fernandez A, Mojica E, Martinez-Indart L, Mintegi S, Benito J. Initial Asthma Severity Assessment Tools as Predictors of Hospitalization. J Emerg Med. 2017 Jul;53(1):10-17. doi: 10.1016/j.jemermed.2017.03.021. Epub 2017 Apr 14. |
| 14621112 | Background | Roussos C, Koutsoukou A. Respiratory failure. Eur Respir J Suppl. 2003 Nov;47:3s-14s. doi: 10.1183/09031936.03.00038503. |
| 10424915 | Background | Beveridge R, Ducharme J, Janes L, Beaulieu S, Walter S. Reliability of the Canadian emergency department triage and acuity scale: interrater agreement. Ann Emerg Med. 1999 Aug;34(2):155-9. doi: 10.1016/s0196-0644(99)70223-4. |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |