Elderly Frequently 'Undertriaged' in Emergency Departments

Elderly Frequently 'Undertriaged' in Emergency Departments

"Finally, the authors investigated reasons for inadequate triage. The most common reason for undertriage was neglect of high-risk situations, sometimes in combination with abnormal vital signs or in combination with severe pain or distress.
The second most important reason for undertriage was inappropriate interpretation of vital signs, sometimes in combination with severe pain or distress, high-risk situations, or an altered mental status.
"[I]nadequate triage appears to be due to a lack of adherence to the Emergency Severity Index algorithm rather than to an inherent deficit of the algorithm itself," the researchers conclude."


Ann Emerg Med. Published online March 9, 2012. Abstract
Conclusion
"In our study, older patients were at risk for undertriage. However, our results suggest that the Emergency Severity Index is reliable and valid for triage of older patients."

Editorial: The heterogeneity of epithelial ovarian cancer. Getting it right David M. Gershenson

Editorial
The heterogeneity of epithelial ovarian cancer
Getting it right

David M. Gershenson, MD *
Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
email: David M. Gershenson (DGERSHEN@mdanderson.org)

Abstract
Epithelial ovarian cancer is heterogeneous and comprises 4 major rare subtypes - mucinous, clear cell, low-grade serous, and endometrioid - all distinct from the more common high-grade serous carcinoma. Women with uncommon histotypes should be triaged to separate clinical trials.