Ce cours est destiné aux équipes soignantes médecin et non médecin des structures d'urgence.

Le triage des patients consultant en SU est nécessaire lorsque le flux dépasse les capacités de prise en charge immédiate. Ce triage a pour fonction première d'optimiser les délais et les circuits de prise en charge. Il permet de mettre en œuvre les démarches diagnostiques et thérapeutiques conformes à l'état de l'art. Il permet une orientation initiale cohérente au sein, voire en dehors, de la SU et de gagner ainsi en efficience.


Introduction 

The FRench Emergency Nurses Classification in Hospital scale (FRENCH) is the first French triage tool for patients visiting an emergency department. The FRENCH scale modified in 2006, based on about 100 determinants (complaints, signs, and vital parameters), allows the triage of adult patients according to five increasing levels of complexity/severity. We evaluated FRENCH version 2 (v.2) in our emergency department. 

Methods 

Reliability was evaluated on 300 prospectively selected patient records (50% of patients admitted). Three nurse pairs, blinded with respect to the original triage, retrospectively and independently triaged 100 patients. Interrater reliability within the pairs was measured with a weighted j. Validity was evaluated on all triaged patients (N = 941) over 14 days by studying the relationships between the original triage category assigned by the triage nurse and resource consumption and the admission rate. 

Results 

Interrater reliability was good [K= 0.77 (95% confidence interval: 0.71–0.82)]. Distribution of the 941 patients included in the validation study (18% of whom were admitted) was as follows [n (%)]: 2 (0.2), 33 (4), 258 (27), 451 (48), and 197 (21) for a triage from 1 to 5, respectively. Resource consumption correlated well with case severity as assessed by the triage category (R = – 0.643, P < 0.0001). Finally, the area under the receiver operating characteristic curve for prediction of admission as a function of triage was 0.858 (95% confidence interval: 0.831–0.885). 

Conclusion 

FRENCH v.2 is a reliable and validated triage tool to predict the complexity/severity of a patient in our emergency department.