A study of the effect of introduction of JTAS in the emergency room

• Published in: Acute medicine & surgery Vol. 4; no. 3; pp. 262 - 270
• Main Authors: Koyama, Toru, Kashima, Takeshi, Yamamoto, Motoyoshi, Ouchi, Kenjiro, Kotoku, Takayuki, Mizuno, Yuta
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.07.2017; John Wiley and Sons Inc
• Subjects: Acute coronary syndromes; Afterward inspection; emergency department crowding; Emergency medical care; Intubation; Original; US‐originated emergency medicine; United States > US; Japan; Afterward inspection; US‐originated emergency medicine; emergency department crowding
• ISSN: 2052-8817; 2052-8817
• DOI: 10.1002/ams2.266

Aim The purpose of this study was to better understand the effects of introducing the Japan Triage and Acuity Scale (JTAS) in the emergency room for walk‐in patients. Methods A simple triage was used in Term A (from April 2006 to December 2010, 4 years and 9 months) and the JTAS was introduced in Term B (from January 2011 to September 2015, 4 years and 9 months). The number of patients who had a sudden turn for the worse after arrival in the emergency room and the time between attendance and emergency catheterization (TBAEC) due to acute coronary syndrome were reviewed. Results There were 653 patients in Term A and 626 patients in Term B who were finally diagnosed as having serious causes. There was no significant difference in the frequency of a sudden turn for the worse between the two terms. There were 182 patients in Term A and 167 patients in Term B who underwent emergency catheterization due to acute coronary syndrome. When ST elevation was recognized in the first electrocardiogram, the median time between attendance and medical attention during Term B improved significantly, by 4.5 min. However, there was no significant difference in medians for TBAEC. When ST elevation was not recognized, there was no significant difference between the two terms, neither in terms of median time between attendance and medical attention, nor TBAEC. Conclusion The data suggests that the effects of introducing the JTAS in the emergency room were restrictive in these two aspects. There was no significant difference in the frequency of a sudden turn for the worse between the two terms. When ST elevation was recognized in the first electrocardiogram, median time between attendance and medical attention of Term B improved significantly, by 4.5 min. The data suggests that the effects of introducing the JTAS in the emergency room were restrictive.