If you look at how people decide where and when to go for medical attention,
they use a mixture of personal experience and lay-triage from family and
friends. They frequently make serious errors (eg: John Smith the Labour
Leader's death from an MI). Access to a 24 hour telephone help line is
aimed at improving their decision making. The fact that it is more
comfortable for us to have 10 patients die from their own stupidity than to
have one die from our stupidity is not an acceptable argument against the
use of telephone triage.
> My department has effective triage 24 hours a day! One of the reasons why it
> is effective is because it avails itself of certain skills impossible to use
> on the telephone. Triage also allows you to make a problem minor by, say,
> stopping bleeding a lot faster than a phone message would.
But people have phones in their homes - few of them have a triage nurse at
home. I personally have given telephone advice to stop bleeding and it is
very effective. Surely this is better than the punters loosing 2 pints of
blood on the way to your dept (and risking an RTA in the process).
> Of course, some people might find they have taken an unnecessary trip to
> GP/A&E when a telephone message could have given them all the information
> they needed, instead of the triage doc/nurse providing it. But at least they
> do not suffer potential harm caused by them unintentionally mis-informing a
> telephone advice service about their condition through ignorance.
I do telephone triage daily (as all GPs have done since the invention of the
telephone). You are right it is not 100% safe which is why the systems are
designed to over triage (a common criticism). However, the alternative is to
tell everyone to go to hospital which is the ultimate in over-triage!.
In the end the only real alternative to telephone triage is to create 20
million hospital beds and pass a law saying everyone must live in the A+E
dept or train 20 million triage nurses and billet them in every house in the
country.
Robbie Coull
email: [log in to unmask] website: http://www.coull.net
DISCLAIMER AND CONFIDENTIALITY NOTICE
This document should only be read by those persons to whom it is addressed
and it is not intended to be relied upon by any person without subsequent
written confirmation of its contents. Accordingly the author disclaims all
responsibility and accepts no liability (including in negligence) for the
consequences of any person acting or refraining from acting on such
information prior to the receipt by those persons of subsequent written
confirmation. This document may contain confidential information belonging
to the sender which is protected by the physician-patient privilege.
If you have received this e-mail in error, please notify the author. Please
also destroy and delete the message from your computer. Any form of
unauthorised reproduction, dissemination, copying, disclosure, modification,
distribution and/or publication of this e-mail message is strictly
prohibited.
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|