Work of Breathing Assessment in Triage Scale

Study Overview
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Brief Summary
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The proposed research study will be a prospective observational study designed to validate the Canadian Triage Assessment Scale (CTAS) in regard to work of breathing in patients in the emergency department. The investigators will assess inter-rater agreement between nurses & emergency physicians for assessment of work of breathing.

Detailed Description
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Investigators will enroll a convenience sample of consenting patients who present to the emergency department with a chief complaint related to respiratory symptoms, including shortness of breath, cough, difficulty breathing, hypoxemia, or any other respiratory related complaint. Following consent and in a blinded fashion, the nurse & emergency physician will be asked to evaluate the patient's work of breathing into three subjective categories: mild, moderate, or severe. The two evaluators will not be aware of the others evaluation of the patient. Evaluators will also be asked to predict the patients likely need for intervention & disposition. Subsequently, investigators will perform a chart review to determine the patient's clinical interventions, outcomes, and dispositions, and evaluate the assessment of the patients work of breathing.

Official Title
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Work of Breathing Assessment in Triage Scale

Conditions
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Shortness of Breath, Respiratory Symptoms, Cough, Difficulty Breathing, Hypoxemia

Intervention / Treatment
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* Other: Canadian Triage Assessment Scale (CTAS)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years of age of older Presenting to the emergency department with a chief complaint of any type of respiratory symptom. Exclusion Criteria: Under 18 years of age Refusal to consent to study Incarcerated patients Pregnant patients Unable to complete survey due to clinical instability, severe pain, or disorientation determined by a study physician.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with Respiratory Symptoms<br>The Canadian Triage Assessment Scale (CTAS) will be assessed via patient survey form and electronic chart review. | Other: Canadian Triage Assessment Scale (CTAS)<br>* The CTAS incorporates work of breathing into a subjective measurement in its assessment of patients and triaged.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Inter-rater agreement between nurses and emergency physicians for the respiratory component of the Canadian Assessment Scale (CTAS) | The CTAS is utilized to qualitatively define work of breathing as severe, moderate, or mild. Kappa will be calculated to assess inter-rater reliability | 24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Emergency Room, Respiratory Assessment, Work of Breathing