Primary care in accident and emergency departments

BMJ 1995;311:1438 (25 November)

Letters

Primary care in accident and emergency departments

Outcomes of study cast doubt on sensitivity of triage decisionsand triage criteria

EDITOR,--Jeremy Dale and colleagues highlight the difficultand unresolved problem of appropriate triage for patients attendingaccident and emergency departments with "primary care" typeproblems.¹ We have had a primary care service in our accidentand emergency department since February 1993, which we recentlyanalysed.²

At St Mary's Hospital we developed a triage decision tree tohelp nurses differentiate between accident and emergncy andgeneral practice patients. Those presenting with minor injuriesconsidered to be unlikely to require radiography were channelledto see a general practitioner, while those likely to need aradiographic investigation were directed to an accident andemergency doctor. We think that it is appropriate to includethis differentiation in the triage scheme because general practitionersare not specifically trained in interpreting x ray films. Inthe community general practitioners receive a radiologist'sreport . . . [Full text of this article]

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Relevant Article

Primary care in the accident and emergency department: I. Prospective identification of patients: Jeremy Dale, Judith Green, Fiona Reid, and Edward Glucksman
BMJ 1995 311: 423-426. [Abstract] [Full Text]