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2016 ; 3
(2
): 101-106
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Utility of blood lactate level in triage
#MMPMID29123760
Fukumoto Y
; Inoue Y
; Takeuchi Y
; Hoshino T
; Nakamura Y
; Ishikawa K
; Morikawa M
; Suginaka H
; Sueyoshi K
; Sumi Y
; Matsuda S
; Okamoto K
; Tanaka H
Acute Med Surg
2016[Apr]; 3
(2
): 101-106
PMID29123760
show ga
AIM: Simple Triage and Rapid Treatment (START) is commonly used at disaster
scenes. The Canadian Emergency Department Triage and Acuity Scale (CTAS) is used
in urban and rural emergency departments (ED). However, triage is not always
accurate or appropriate. The blood lactate level (BLL) is a major biomarker of
physical status. We measured BLL using the Lactate Pro-1710 Test Meter in all
patients transported to our ED and assessed their correlation with the triage
level determined using START and the CTAS. METHODS: This retrospective study
included 510 patients admitted to our ED between January 2011 and July 2012 whose
BLL was measured. The patients were classified into triage divisions (green,
yellow, red, and black) according to vital signs and chief complaints, and
correlations among BLL, triage level, and prognosis were assessed in all groups.
RESULTS: Of the total, 62 patients had cardiopulmonary arrest (CPA), 262 had
internal pathologies, and 186 had external pathologies. Significant correlations
were observed between BLL and both START and CTAS triage. Also BLL was
significantly higher in severe patients categorized with START and CTAS (P <
0.0001), especially in the death group when the patients were divided into two
groups according to prognosis (P < 0.0001). Two patients categorized yellow with
START died during the hospitalization, however BLL of these two patients were
high on admission at the ED. CONCLUSION: BLL could be used to correct the triage
level, and decide the priority of treatment and transportation even within the
same triage level, thereby avoiding under-triage.