Reliability and performance of the Swiss Emergency Triage Scale used by paramedics.
European Journal of Emergency Medicine · 2017-12-19 · Method & validation
Abstract
OBJECTIVES: No general emergency department triage scale has been evaluated for prehospital triage. The objective of this study was to evaluate the reliability and the performance of the Swiss Emergency Triage Scale (SETS) used by paramedics to determine the emergency level and orientation of simulated patients. PATIENTS AND METHODS: In a prospective cross-sectional study, 23 paramedics evaluated 28 clinical scenarios with the SETS using interactive computerized triage software simulating real-life triage. The primary outcome was inter-rater reliability regarding the triage level among participants measured by intraclass correlation coefficient (ICC). Secondary outcomes were the accuracy of triage level and the reliability and accuracy of orientation of patients of at least 75 years to a dedicated geriatric emergency centre. RESULTS: Twenty-three paramedics completed the evaluation of the 28 scenarios (644 triage decisions). Overall, ICC for triage level was 0.84 (95% confidence interval: 0.77-0.99). Correct emergency level was assigned in 89% of cases, overtriage rate was 4.8%, and undertriage was 6.2%. ICC regarding orientation in the subgroup of simulated patients of at least 75 years was 0.76 (95% confidence interval: 0.61-0.89), with 93% correct orientation. CONCLUSION: Reliability of paramedics rating simulated emergency situations using the SETS was excellent, and the accuracy of their rating was very high. This suggests that in Switzerland, the SETS could be safely used in the prehospital setting by paramedics to determine the level of emergency and guide patients to the most appropriate hospital.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Older adults · Paramedics & EMTs · Triage instruments
Related articles
- Out-of-Hospital Triage of Older Adults With Head Injury: A Retrospective Study of the Effect of Adding "Anticoagulation or Antiplatelet Medication Use" as a Criterion. (Ann Emerg Med, 2017)
- Temporal trends in falls cases seen by EMS in Melbourne: The effect of residence on time of day and day of week patterns. (Injury, 2016)
- Evaluating pre-hospital triage and decision-making in patients who died within 30 days post-trauma: A multi-site, multi-center, cohort study. (Injury, 2022)
- Developing a national triage tool for use in NHS regional trauma networks: the MATTS mixed methods study. (Health Technol Assess, 2026)
- Prehospital Large-Vessel Occlusion Stroke Detection Scales: A Pooled Individual Patient Data Analysis of 2 Prospective Cohorts. (Neurology, 2025)
- The reliability and validity of triage tools in geriatric emergency departments: A scoping review. (Int Emerg Nurs, 2024)