Risk classification and screening protocols for adults and elderly in emergency: Integrative review
DOI:
https://doi.org/10.36489/saudecoletiva.2022v12i78p10964-10975Keywords:
Emergencies, Emergency Medical Services, Emergency Identification, Triage, ProtocolsAbstract
Objective: to identify in the scientific literature the risk classification and screening protocols for adults and the elderly in emergencies. Methods: this is an integrative review. Primary articles that used risk classification and triage protocols in emergencies, without time limit and published in any language, were included. The guiding question was based on the acronym PICo: Population, Interest and Context. The following databases were used for collection: CINAHL; MEDLINE via the PubMed portal; LILACS via VHL and Web of Science. Data selection was performed by reading the titles, abstracts and full text. Results: 11 articles were selected in which emergency severity, hospital triage, neurological and trauma protocols were identified. Conclusion: the risk classification and screening protocols found in the scientific literature were heterogeneous, they were effective and feasible to be used according to the needs of the country for which it is intended.
References
Lindner G, Woitok BK. Emergency department overcrowding. Wien Klin Wochenschr [Internet]. 2020 [cited 2022 Mar 12]. Available from: https://link.springer.com/article/10.1007%2Fs00508-019-01596-7.
Silva PL, Paiva L, Faria VB, Ohl RIB, Chavaglia SRR. Reception with risk classification of the Adult Emergency Service: user satisfaction. Rev esc enferm USP [Internet]. 2016 [cited 2022 Mar 12];50(3):427-33. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S008062342016000300427&lng=en.
Sacoman TM, Beltrammi DGM, Rosemarie A, Cecílio LCO, Reis AAC. Implementation of the Manchester risk rating system in a municipal emergency netwok. Saúde debate [Internet]. 2019 [cited 2022 Mar 12]; 43(121):354-67. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S010311042019000200354&lng=en.
Selva TS, Peiró S, Pina PS, Espín CM, Aguilera IL. Validez del protocolo de adecuación de urgências hospitalarias. Revista Española de Salud Publica [Internet]. 1999 [cited 2022 June 21]; 73(4):465-79. Available from: https://scielo.isciii.es/pdf/resp/v73n4/protocolo.pdf.
Leite DHB, Santos SMJ, Nascimento ACL, Dantas GHO, Lucena HKV, Medeiros, IML. Validação do conteúdo do instrumento de triagem e classificação de risco utilizado nas unidades de pronto atendimento. Saúde Coletiva [Internet]. 2021 [cited 2022 June 21]; 11(66):6393–402. Available from: https://doi.org/10.36489/saudecoletiva.2021v11i66p6393-6402
Ministério da Saúde (MS). Secretaria Executiva. Núcleo Técnico da política Nacional de Humanização. Humaniza SUS: Acolhimento com classificação de risco - um paradigma ético-estético no fazer em saúde [Internet]. Brasília, 2004 [cited 2022 Mar 12]. Available from: http://www.saude.sp.gov.br/resources/humanizacao/biblioteca/pnh/acolhimento_com_avaliacao_e_classificacao_de_risco.pdf
Ministério da Saúde (MS). Secretaria de Atenção à Saúde. Política Nacional de Humanização da Atenção e Gestão do SUS. HumanizaSUS - Acolhimento e classificação de risco nos serviços de urgência [Internet]. Brasília, 2009 [cited 2022 Mar 12]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/acolhimento_classificaao_risco_servico_urgencia.pdf
Soares ACL, Brasileiro M, Souza DG. Embracement with risk classification: the nurse's action in urgency and emergency. Rev Científica Enferm [Internet]. 2018 [cited 2022 Mar 12];8(22):22-33. Available from: https://www.recien.com.br/index.php/Recien/article/view/245.
Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs [Internet]. 2005 [cited 2022 Mar 12];52(5):546-53. Available from: https://pubmed.ncbi.nlm.nih.gov/16268861/ doi: 10.1111/j.1365-2648.2005.03621.
Lockwood C, Porrit K, Munn Z, Rittenmeyer L, Salmond S, Bjerrum M, et al. Chapter 2: Systematic reviews of qualitative evidence. In: Aromataris E, Munn Z, editors. Joanna Briggs Institute, 2017 [cited 2022 Mar 12]. Available from: https://reviewersmanual. joannabriggs.org
Marziale MH. Data colecttion instrument integrative review. [Internet]. 2015 [cited 2022 Mar 12]. Available from: http://grupodepesquisa.eerp.usp.br/sites/redenso/wpcontent/uploads/sites/9/2016/04/Instrumiento-revision-de-la-literatura-RedENSO-2017.pdf
Melnyk, BM, Fineout-Overhol TE. Evidence-based practice in nursing and health care: a guide to best practice. Philadelphia: lippincott, Williams & Wilkins; 2011.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and MetaAnalyses: The PRISMA Statement. PLoS Med. [Internet]. 2009 [cited 2022 Mar 12];6(6):e1000097. Available from: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000097.
Wuerz RC, Milne LW, Eitel DR, Travers D, Gilboy N. Reliability and validity of a new five-level triage instrument. Academic emerg med [Internet]. 2000 [cited 2022 Mar 12]; 7(3): 236-42. Available from: https://pubmed.ncbi.nlm.nih.gov/10730830/ doi: 10.1111/j.1553-2712.2000.tb01066.x.
Govindarajan P, Ghilarducci D, McCulloch C, Pierog J, Bloom E, Johnston C. Comparative evaluation of stroke triage algorithms for emergency medical dispatchers (MeDS): prospective cohort study protocol. BMC Neurology [Internet]. 2011 [cited 2022 Mar 12],11(14):1-8. Available from: http://www.biomedcentral.com/1471-2377/11/14.
Souza CC, Chianca TCM, Cordeiro Junior W, Rausch MCP, Nascimento GFL. Reliability analysis of the Manchester Triage System: inter-observer and intra-observer agreement. Rev Latino-Am Enfermagem [Internet]. 2018 [cited 2022 Mar 12];26:e3005. Available from: https://www.scielo.br/scielo.php?pid=S0104-11692018000100328&script=sci_abstract.
Santiago AKC, Nogueira LT, Gonçalves LC, Santos AMR, Avelino FVSD. User embracement with evaluation and classification of risk: perception of nurses. Rev enferm UFPE on line [Internet]. 2012 [cited 2022 Mar 12];6(9):2127-35. Available from: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/download/7318/6779
Haider AA, Azim A, Rhee P, Kulyatunyou N, Ibraheem K, Tang A et al. Substituting systolic blood pressure with shock index in the National Trauma Triage Protocol. J Trauma Acute Care Surg [Internet]. 2016 [cited 2022 Mar 12];81(6):1136-41. Available from: https://pubmed.ncbi.nlm.nih.gov/27893619/.
Opiro K, Wallis L, Ogwang M. Assessment of hospital-based adult triage at emergency receiving áreas in hospitals in Northern Uganda. Afri Health Sci [Internet]. 2017 [cited 2022 Mar 12];17(2):481-490. Available from: https://pubmed.ncbi.nlm.nih.gov/29062344/ doi:10.4314/ahs.v17i2.23
Marconato RS, Monteiro MI. Risk classification priorities in an emergency unit and outcomes of the service provided. Rev Latino-Am. Enfermagem [Internet]. 2017 [cited 2022 Mar 12];25: e2974. Available from: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S010411692017000100407&lng=en&nrm=iso.
Abualenain J, Almarzouki A, Saimaldaher R, Zocchi MS, Pines JM et al. The effect of point-of-care testing at triage: na observational study in a teaching hospital in Saudi Arabia. Wes J Emerg Med [Internet]. 2018 [cited 2022 Mar 12];19(5):884-8. Available from: https://pubmed.ncbi.nlm.nih.gov/30202503/
Souza CC, Toledo AD, Tadeu LFR, Chianca TCM. Risk classification in the emergency room: agreement between a Brazilian and Manchester institutional protocol. Rev Latino-Am Enfermagem [Internet]. 2011 [cited 2022 Mar 12];19(1):[08 telas]. Available from; https://www.scielo.br/scielo.php?pid=S010411692011000100005&script=sci_abstract&tlng=pt.
Suthersan Y, Theerawit P, Suporn A, Nongnuch A, Phanachet P, Kositchaiwa C. The impact of introducing the early warning scoring system and protocol on clinical outcomes in tertiary referral university hospital. Ther Clin Risk Manag [Internet]. 2018 [cited 2022 Mar 12]:14 2089–95. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205530/ doi: 10.2147/TCRM.S175092
Rein EAJV, Sluijs RVD, Voskens FJ, Lansink K, Houwert RM, Lichtveld RA et al. Development and validation of a prediction model for prehospital triage of trauma patients. JAMA Surg [Internet]. 2019 [cited 2022 Mar 12];154(5):421-9. Available from: https://jamanetwork.com/journals/jamasurgery/fullarticle/2723266 doi:10.1001/jamasurg.2018.4752
Zhao L. Advanced Triage Protocols in the Emergency Department. Tese [Doctorate in Nursing]- Walden University; 2017 [cited 2022 Mar 12]. Available from: https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=4752&context=dissertations
Matozinhos FP, Silverio IR Boaventura JG, Silva TPR, Corrêa AR. Analysis of screening and assistance to women victims of traffic accidents. Rev Bras Enferm [Internet]. 2019 [cited 2022 Mar 12];72(4):1013-9. Available from: https://www.scielo.br/scielo.php?script=sci_abstract&pid=S003471672019000401013&lng=pt&nrm=iso doi: 10.1590/0034-7167-2018-0727
Campos GMS, Medeiros I, Lara JS, Maldonado RS, Tondorf TV. Screening: The method that priorities life. Rev Eletr UNIVAG [Internet]. 2016 [cited 2022 Mar 12];1(15):88-104. Available from: https://www.periodicos.univag.com.br/index.php/CONNECTIONLINE/article/view/349 doi: 10.18312%2Fconnectionline.v0i15.349