A New Vital Sign in Determining the Triage Category in Emergency Department Presentations: End-Tidal Carbon Dioxide

Fatma Tortum; Ali Gur; Ayça Calbay; Omer Turalioglu; Erdal Tekin

doi:10.58600/eurjther1819

Authors

Fatma Tortum Atatürk University Faculty of Medicine, Department of Emergency Medicine, Erzurum, Turkey https://orcid.org/0000-0002-1876-5998
Ali Gur Atatürk University Faculty of Medicine, Department of Emergency Medicine, Erzurum, Turkey https://orcid.org/0000-0002-7823-0266
Ayça Calbay Atatürk University Faculty of Medicine, Department of Emergency Medicine, Erzurum, Turkey https://orcid.org/0000-0002-7031-2689
Omer Turalioglu Atatürk University Faculty of Medicine, Department of Emergency Medicine, Erzurum, Turkey https://orcid.org/0009-0004-1710-6108
Erdal Tekin Atatürk University Faculty of Medicine, Department of Emergency Medicine, Erzurum, Turkey https://orcid.org/0000-0002-6158-0286

DOI:

https://doi.org/10.58600/eurjther1819

Keywords:

Emergency triage, end-tidal carbon dioxide, triage category, vital sign, hospitalization

Abstract

Objective: To investigate whether patients’ end-tidal carbon dioxide (ETCO₂) values measured at the time of their presentation to the emergency department can be used together with vital signs in determining their triage categories and predicting hospitalization.

Material and method: This prospective, observational, cross-sectional study was conducted between May 1, 2023, and June 1, 2023, at the emergency department of a tertiary hospital. The study included patients aged >18 years who presented to the emergency department and were evaluated to have a triage category of level 2, 3, or 4 according to the five-step triage system. The patients’ vital signs were measured at the time of their presentation to the emergency department and the ETCO₂values measured through a nasal cannula were statistically evaluated in terms of their relationship with triage categories and hospitalization indications.

Results: A total of 1,100 patients were included in the study. According to the triage category of the patients, the mean ETCO₂values for triage levels 2, 3, and 4 were 27.1±3.6, 30.6±3.1, and 35.4±3.5, respectively, indicating statistically significant differences (p<0.001). When the relationship of ETCO₂and vital signs with hospitalization indications evaluated at the emergency department was examined, the area under the receiver operating characteristic curve for ETCO₂was 0.733, which was statistically significant (p<0.001).

Conclusion: On completion of the study, it was concluded that the ETCO₂values measured at the time of presentation to the emergency department can be a new vital sign that can be used to determine the triage categories of patients and identify those who require hospitalization.

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References

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