Advanced Journal of Emergency Medicine最新文献

{"title":"Current Medical Journalism Needs Major Revisions.","authors":"Alireza Baratloo","doi":"10.22114/AJEM.v0i0.90","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.90","url":null,"abstract":"Medical journalism commenced during early nineteenth century as an impressive adjunct for medical education. It is considered as a platform to share the results of the research studies and to disseminate medical information that could impact the present concept and practice of the medicine field. Medical journalism gained immense attention over the years; however, the present scenario revealed certain limitations. \u0000A rise in the number of researchers, by interest or forcefully, has led to an increase in the journal count, resulting in several fake research articles being published in the journals. This leads to inappropriate research and low quality of journals, where the data appearing in the research articles is not authentic; thus, the journals publishing such articles face several issues while verifying the authenticity of the data provided. \u0000All journals, in particular, the recent ones strive to achieve immense importance in regards to the impact factor, h-index, and similar quality assessments; however, attaining similar scores as that of the well-known journals is impossible. Hence, as a futile effort, the editorial team of the new or latest journals consider adding more references in their articles in order to achieve a higher score; however, certain references from the previously published papers, may decode as a conflict of interest. \u0000Based on an unwritten and unavailable rule, all new journals try to publish papers in same format as publishing in famous journals, and do not dare to deconstruct it. It seems that deconstruction should also be performed by the old journals founded the current style! \u0000In order to avoid the aforementioned issues, the Advanced Journal of Emergency Medicine emerged with the concept of being different, deconstructive, and without any futile competition with the other journals. Accordingly, we consider a large audience with several degrees of medical education to participate in the field of research, make the journal a unique one aim to augment of medical education through medical research charm.  \u0000To the best of our knowledge, at present, we do not have appropriate solutions to aforementioned problems. We request the authors, directors, and editorial members of the journals to have a detailed discussion on this topic, and we are ready to publish articles on the topic that is briefly discussed in this article.","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"2 3","pages":"e26"},"PeriodicalIF":0.0,"publicationDate":"2018-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/a2/AJEM-2-e26.PMC6549200.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40450955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Focused Assessment with Sonography for Blunt Abdominal Trauma in Pediatric Patients Performed by Emergency Medicine Residents versus Radiology Residents.","authors":"Farhad Heydari,&nbsp;Ayoub Ashrafi,&nbsp;Mohsen Kolahdouzan","doi":"10.22114/AJEM.v0i0.89","DOIUrl":"10.22114/AJEM.v0i0.89","url":null,"abstract":"<p><strong>Introduction: </strong>Focused assessment with sonography for trauma (FAST) has been shown to be useful to detect intraperitoneal free fluid in patients with blunt abdominal trauma (BAT).</p><p><strong>Objective: </strong>We compared the diagnostic accuracy of FAST performed by emergency medicine residents (EMRs) and radiology residents (RRs) in pediatric patients with BAT.</p><p><strong>Method: </strong>In this prospective study, pediatric patients with BAT and high energy trauma who were referred to the emergency department (ED) at Al-Zahra and Kashani hospitals in Isfahan, Iran, were evaluated using FAST, first by EMRs and subsequently by RRs. The reports provided by the two resident groups were compared with the final outcome based on the results of the abdominal computed tomography (CT), operative exploration, and clinical observation.</p><p><strong>Results: </strong>A total of 101 patients with a median age of 6.75 ± 3.2 years were enrolled in the study between January 2013 and May 2014. These patients were evaluated using FAST, first by EMRs and subsequently by RRs. A good diagnostic agreement was noted between the results of the FAST scans performed by EMRs and RRs (κ = 0.865, P < 0.001). The sensitivity, specificity, positive and negative predictive values, and accuracy in evaluating the intraperitoneal free fluid were 72.2%, 85.5%, 52%, 93.3%, and 83.2%, respectively, when FAST was performed by EMRs and 72.2%, 86.7%, 54.2%, 93.5%, and 84.2%, respectively, when FAST was performed by RRs. No significant differences were seen between the EMR- and RR-performed FAST.</p><p><strong>Conclusion: </strong>In this study, FAST performed by EMRs had acceptable diagnostic value, similar to that performed by RRs, in patients with BAT.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"2 3","pages":"e31"},"PeriodicalIF":0.0,"publicationDate":"2018-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.22114/AJEM.v0i0.89","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40539912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 69-year-old Man with Sudden Loss of Consciousness, Non-reactive Pupils, and a Bilateral Positive Babinski Sign.","authors":"Mehran Sotoodehnia,&nbsp;Mehrnoosh Aligholi-Zahraie","doi":"10.22114/AJEM.v0i0.86","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.86","url":null,"abstract":"LEARNING POINTS: Pathologic findings In figure 1, the basilar artery appears homogenously hyperdense in comparison with the adjacent left middle cerebral artery (MCA), using brain parenchyma as a reference point; thus indicating a hyperdense basilar artery sign (HBAS) (Figure 2, white arrow). Also, the right superior cerebellar artery and left posterior cerebral artery appear to be hyperdense (Figure 2, the red and green arrows, respectively). This is called a hyperdense artery sign (HAS). The artery becomes hyperdense because the intra-arterial clotted blood has a higher Hounsfield unit (80 HU) than the non-clotted flowing blood (40 HU) and thus appears white on non-contrast computed tomography (CT) scan. Pathologically, high hematocrit levels and calcium deposits in the vessel wall (due to arteriosclerotic disease) can result in an incorrect diagnosis of HAS. Sometimes, infections or tumors can make the brain parenchyma surrounding the vessel hypodense, which can give the false impression of a hyperdense vessel (1). To avoid misdiagnosis, these considerations are useful:  Ensure the attenuation value (Hounsfield units) of all intracranial arteries and veins are nearly the same when there are high hematocrit levels.  Calcifications are usually located at the periphery of the vessels.  In contrast to atheromatous calcifications, a hyperdensity thought to be a HAS is reversible (2).  Koo et al. defined hyperdensity as an absolute density of > 43 HU and a MCA ratio (the ratio of the dense MCA to the contralateral MCA) of > 1.2. He showed that using a combination of these two parameters had 100% specificity for the HAS for acute ischemic stroke cases (3). Importance Acute basilar artery occlusion (BAO) is a rare catastrophic form of stroke, roughly causing around 1% of all strokes (4). BAO occurs usually due to an embolus with a cardiac or large vessel origin, or the formation of a local atherosclerotic thrombosis. In this patient, BAO occurred soon after myocardial infarction. Depending on the location and extent of occlusion and on the degree of collateral flow, BAO has quite variable clinical and imaging manifestations. The clinical presentation of BAO ranges from nonspecific symptoms such as headache, neck pain, or vertigo to severe disabilities such as decreased consciousness, hemiplegia or quadriplegia, extensor plantar sign, dysarthria, dysphagia, aphagia, ataxia, nuclear oculomotor nerve palsy, bilateral ptosis, anisocoria, non-reactive pupils, Figure 1: Axial non-enhanced computed tomography scan of the patient’s brain Mehran Sotoodehnia*, Mehrnoosh Aligholi-Zahraie","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"2 3","pages":"e39"},"PeriodicalIF":0.0,"publicationDate":"2018-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/9c/AJEM-2-e39.PMC6549201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40450843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-ST-Elevation Myocardial Infarction in a Case of Von Willebrand Disease: a Case Report.","authors":"Anees Abdul,&nbsp;Arpith Easo Samuel,&nbsp;Fabith Moideen,&nbsp;Jayasree Nambiar","doi":"10.22114/AJEM.v0i0.85","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.85","url":null,"abstract":"<p><strong>Introduction: </strong>Studies have shown that patients with Von Willebrand disease (VWD) have decreased prevalence of thrombotic events like myocardial infarction (MI). Here we describe a case of VWD with acute non-ST-elevation MI with ongoing bleeding manifestations.</p><p><strong>Case presentation: </strong>A 37-year-old female patient presented to the emergency department with a complaint of central chest pain since 7 days. She also had a history of hemoptysis since 8 days. Electrocardiogram (ECG) revealed ST-segment depression in leads I, aVL, II, III, aVF, and V₄-V₆ compatible with diagnosis of Non-ST-Elevation Myocardial Infarction (Non STEMI). She was started on nitroglycerine infusion, angiotensin II receptor blockers, and calcium channel blockers along with trimetazidine. Her chest pain and ECG changes settled after 2 days, and she was discharged in a stable condition.</p><p><strong>Conclusion: </strong>There are limited studies available regarding the management of acute MI in VWD patients with acute bleeding manifestations. Further studies have to be carried out to determine successful ways of managing thrombotic events like MI in this subset of patients.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"2 4","pages":"e47"},"PeriodicalIF":0.0,"publicationDate":"2018-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/4e/AJEM-2-e47.PMC6548152.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40450030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Interesting Case of Isolated Pancreatic Transection Following Blunt Abdominal Trauma in Emergency Department.","authors":"Devendra Richhariya,&nbsp;Vivekanshu Verm,&nbsp;Yatin Mehta","doi":"10.22114/AJEM.v0i0.87","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.87","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic injury to the pancreas is not common, but if the diagnosis is delayed or misdiagnosed in the emergency department (ED), the condition is associated with high morbidity and mortality and raises a question about the quality of emergency care. Here, we describe a rare case of blunt abdominal trauma resulted in isolated pancreas injury.</p><p><strong>Case presentation: </strong>A 25-year-old young male came to our emergency room (ER) in a conscious, anxious state from a nearby town with a history of roadside trauma. Further investigations revealed an isolated pancreatic injury due to trauma with no other major injuries, which occurred due to a sudden high-speed impact of the steering wheel to the epigastrium of a driver while driving the car, severely compressing the pancreas between the backbone and steering wheel. The patient was admitted to the intensive care unit for close observation and monitoring. He was managed conservatively on intravenous fluids, antibiotics, analgesics, and vasopressors. He was discharged after five days in a hemodynamically stable and afebrile condition, on a normal diet.</p><p><strong>Conclusion: </strong>Isolated pancreatic injury following blunt abdominal trauma is rare, and the symptoms are difficult to analyze early due to its retroperitoneal anatomy. Early detection and early intervention are important in the ED, and if left unrecognized, could result in a poor outcome.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"2 4","pages":"e48"},"PeriodicalIF":0.0,"publicationDate":"2018-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/17/AJEM-2-e48.PMC6548144.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40561953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pituitary Macroprolactinoma with Mildly Elevated Serum Prolactin: Hook Effect.","authors":"Mahnaz Pejman Sani,&nbsp;Mahbube Ebrahimpur,&nbsp;Mohammad Reza Mohajeri-Tehrani","doi":"10.22114/AJEM.v0i0.84","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.84","url":null,"abstract":"A 45-year-old man was admitted in our department with complaints of severe headache for over 6 months period. He also suffered from several problems such as visual field defect, decreased energy and libido, body hair loss, cold intolerance, decreased appetite and dry skin. On physical examination, he was afebrile: BP (blood pressure): 110/70 mm/Hg, PR (pulse rate) :65 beat/min, BMI (body mass index): 24. He had no terminal hair on face or chest and subcutaneous adipose tissue mass had been decreased substantially. Laboratory tests revealed; Hb: 12 g/dL (N: 14–17 g/dL), Total testosterone: 1.2 ng/mL (N:–-10 ng/mL), Luteinizing hormone (LH):3.3MIU/mL (N:1–8 MIU/mL), Follicle Stimulating hormone (FSH):1.3 MIU/mL (N:1–7 MIU/mL), T4:3.4 micg/dL (N:4–12 micg/dL), TSH:0.6 MIU/mL (N:0.5–5 MIU/mL), Prolactin:100 ng/mL (2–24 ng/mL), serum cortisol:6 MIU/mL (N:4–21 MIU/mL), IGF1:162 ng/mL (50–245). Pituitary MRI showed macroadenoma (29*16*14 mm) in left side of sella turcica which bulged to suprasellar cistern with pressure effect on left optic nerve (Figure 1, 2). Visual field examination revealed mild temporal hemianopia. These findings are consistent with macroadenoma and mild prolactin elevation. We also observed a discrepancy between pituitary tumor size and prolactin level. The correct estimate of serum prolactin was obtained after serial dilutional measurement. Serum prolactin after dilution was 6470 ng/mL. With these findings pituitary macroadenoma was diagnosed and treatment with cabergoline (dopamine agonist) 0.5 mg/week was started. After one month follow-up he had no symptoms, visual field defect was improved and pituitary MRI showed significant shrinkage of tumor.","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"2 4","pages":"e49"},"PeriodicalIF":0.0,"publicationDate":"2018-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/b0/AJEM-2-e49.PMC6548154.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40539929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Gorlin-Goltz Syndrome Presented to the Emergency Department as Facial Swelling.","authors":"Suha N Aloosi,&nbsp;Kawa A Mahmood,&nbsp;Shakhawan M Ali,&nbsp;Payman Kh Mahmud,&nbsp;Seerwan O Hasan,&nbsp;Hawbash O Muhamed","doi":"10.22114/AJEM.v0i0.83","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.83","url":null,"abstract":"<p><strong>Introduction: </strong>Gorlin-Goltz syndrome (GGS), also known as basal cell nevus syndrome, is a very rare autosomal dominant inherited disorder that is characterized by the development of numerous basal cell carcinoma. This article reports a case of GGS, emphasizing its clinical and radiographic manifestations.</p><p><strong>Case presentation: </strong>We report here the case of a 35-year-old man who visited the maxillofacial emergency department due to left facial swelling. According to his clinical and radiographic examination we diagnosed him with GGS with no family history. The patient has multiple odontogenic keratocysts, rib anomalies, calcifications of the falx cerebri, lower jaw prognathism, frontal bossing, macrocephaly, and thick eyebrows.</p><p><strong>Conclusion: </strong>A definitive diagnosis of GGS should be made by a multidisciplinary team including a maxillofacial surgeon and medical specialists. Early diagnosis, treatment, and regular follow up are important to decrease complications, including oromaxillofacial deformation and destruction, and possible malignancy.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"2 4","pages":"e46"},"PeriodicalIF":0.0,"publicationDate":"2018-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/f8/AJEM-2-e46.PMC6548149.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40561495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 24-year-old Female Traumatic Patient Following a Car Accident.","authors":"Atousa Akhgar,&nbsp;Seyed-Hasan Imami-Razavi,&nbsp;Shervin Farahmand,&nbsp;Seyedhossein Seyedhosseini-Davarani,&nbsp;Shahram Bagheri-Hariri,&nbsp;Ali Labaf,&nbsp;Mohammad Reza Keramati,&nbsp;Mohammad Zarei,&nbsp;Morteza Noparast,&nbsp;Hadi Mirfazaelian","doi":"10.22114/AJEM.v0i0.82","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.82","url":null,"abstract":"","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"2 3","pages":"e38"},"PeriodicalIF":0.0,"publicationDate":"2018-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/d7/AJEM-2-e38.PMC6549202.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40550275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Based Violence Causing Severe Multiple Injuries; a Case Report.","authors":"Adalard Falschung","doi":"10.22114/AJEM.v0i0.80","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.80","url":null,"abstract":"<p><strong>Introduction: </strong>Gender-based violence (GBV) against women has been identified as a global health and development issue. We reported a case of GBV causing sever, multiple injuries in a middle-aged female.</p><p><strong>Case report: </strong>A 47-year-old woman presented to emergency room with disturbed level of consciousness, shortness of breath and multiple patches of skin discoloration. On examination, the patient was semi-conscious, with multiple ecchymosis and bilateral decreased air entry. Computed tomography scan of the neck and chest showed six rib fractures on the left side, and eight rib fractures on the right side, sternal fracture, manubriosternal dislocation, bilateral hemothorax, fracture of body of 11^th thoracic vertebra, and fracture of cervical spine of 5^th and 7^th vertebrae. The patient was intubated and admitted to intensive care unit. She was discharged with good health condition after 23 days of hospital admission.</p><p><strong>Conclusion: </strong>GBV is still a cause of severe trauma that puts the patient's life at risk.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"2 3","pages":"e35"},"PeriodicalIF":0.0,"publicationDate":"2018-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/b0/AJEM-2-e35.PMC6549195.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40540919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome-Based Validity and Reliability Assessment of Raters Regarding the Admission Triage Level in the Emergency Department: a Cross-Sectional Study.","authors":"Seyedhossein Seyedhosseini-Davarani,&nbsp;Amir Nejati,&nbsp;Hooman Hossein-Nejad,&nbsp;Seyed-Mohammad Mousavi,&nbsp;Mojtaba Sedaghat,&nbsp;Mona Arbab,&nbsp;Shahram Bagheri-Hariri","doi":"10.22114/AJEM.v0i0.76","DOIUrl":"10.22114/AJEM.v0i0.76","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency department (ED) is usually the first line of healthcare supply to patients in non-urgent to critical situations and, if necessary, provides hospital admission. A dynamic system to evaluate patients and allocate priorities is necessary. Such a structure that facilitates patients' flow in the ED is termed triage.</p><p><strong>Objective: </strong>This study was conducted to investigate the validity and reliability of implementation of Emergency Severity Index (ESI) system version 4 by triage nurses in an overcrowded referral hospital with more than 80000 patient admissions per year and an average emergency department occupancy rate of more than 80%.</p><p><strong>Method: </strong>This prospective cross-sectional study was conducted in a tertiary care teaching hospital and trauma center with an emergency medicine residency program. Seven participating expert nurses were asked to assess the ESI level of patients in 30 written scenarios twice within a three-week interval to evaluate the inter-rater and intra-rater reliability. Patients were randomly selected to participate in the study, and the triage level assigned by the nurses was compared with that by the emergency physicians. Finally, based on the patients' charts, an expert panel evaluated the validity of the triage level.</p><p><strong>Results: </strong>During the study period, 527 patients with mean age of 54 ± 7 years, including 253 (48%) women and 274 (52%) men, were assessed by seven trained triage nurses. The degree of retrograde agreement between the collaborated expert panel's evaluation and the actual triage scales by the nurses and physicians for all 5 levels was excellent, with the Cohen's weighted kappa being 0.966 (CI 0.985-0.946, p < 0.001) and 0.813 (CI 0.856-0.769, p<0.001), respectively. The intra-rater reliability was 0.94 (p < 0.0001), and the inter-rater reliability for all the nurses was in perfect agreement with the test result (Cohen's weighted kappa were as follows: 0.919, 0.956, 0.911, 0.955, 0.860, 0.956, and 0.868; p < 0.001).</p><p><strong>Conclusion: </strong>The study findings showed that there was perfect reliability and, overall, almost perfect validity for the triage performed by the studied nurses.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"2 3","pages":"e32"},"PeriodicalIF":0.0,"publicationDate":"2018-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/60/AJEM-2-e32.PMC6549196.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40450947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}