Emergency Medical Services, Hemodynamic Instability, Hypoperfusion, Triage, Vital Signs Monitoring
Conditions
Keywords
Vital parameters, capillary refill time, prediction, Non-trauma Emergency, Emergency Medical Services, Triage, clinical decision-making
Brief summary
This observational study aims to determine the correlation between capillary refill time (CRT) and vital parameters in patients presenting to the emergency department. It explores whether CRT is associated with triage categories and vital signs in non-traumatic patients, including oxygen saturation (SpO₂), heart rate, systolic and diastolic blood pressure, body temperature, forearm temperature, and respiratory rate. Patients admitted to the emergency department of a training and research hospital were assigned triage codes (green, yellow, red). Their CRT was measured three times, and vital signs were recorded accordingly.
Detailed description
In the initial evaluation, patients admitted to the emergency department were assigned a triage color code, categorized as green, yellow, or red. In the color-coding system employed, green was designated as low urgency, yellow as medium urgency, and red as urgent. The allocation of triage codes is the responsibility of nurses who have undergone the requisite training. Following the completion of the assigned task, the emergency specialist proceeded to meticulously record a series of physiological parameters. These parameters included the CRT (in seconds), the percentage of oxygen saturation in the blood (SpO2%), the heart rate (in minutes), the systolic and diastolic blood pressure (in mmHg), the body temperature (in degrees Celsius), the forearm temperature measured at the CRT, and the respiratory rate (in minutes). CRT was evaluated three times for each patient, and the mean of these values was recorded as the CRT.
Interventions
OTHERNo clinical intervention (observational study only)
This is an observational study. No experimental or clinical intervention was applied. Only non-invasive data collection such as capillary refill time and vital sign measurements was performed.
Sponsors
Izmir Democracy University
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
Yes
Inclusion criteria
* individuals over the age of 18 years who consented to participate in the study
Exclusion criteria
* The presence of pregnancy * Multiple traumas resulting in hypovolemia * The absence of fingers or limbs * The utilization of vasopressors or inotropic pharmacological agents * The existence of peripheral arterial disease * The presence of nail polish or fake nails
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Body Temperature | Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room (ER). | Body temperature will be recorded using standard clinical devices. Unit: Degrees Celsius. Body temperature was measured with a Yobekan model KV-11 infrared measuring device. Measurement technique: Measured using infrared thermometer. All vital signs, including body temperature, were assessed sequentially by the same emergency physician within 10 minutes after the patient was transferred to the emergency care room (ER). |
| Respiratory Rate | Following the patient's admission to the ER, the triage nurse determins the patient's triage code. The patient is then assessed by the emergency physician within 10 minutes of being transferred to the ER triage code section. (single timepoint) | respiratory rate will be recorded using standard clinical devices. Unit: Breaths per minute Measurement technique: Measured using observation and counting. |
| Forearm Temperature | Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room (ER). | Forearm temperature will be recorded using standard clinical devices. Unit: Degrees Celsius Measurement technique: Measured using infrared thermometer. |
| Triage Code Assignment | Baseline [within 30 minutes of initial Emergency department admission triage assessment] | Triage code assignment will be completed within the first 30 minutes of the patient's initial presentation to the emergency department (ED). Patients will be categorized into green, yellow, or red triage groups based on standard emergency triage protocols upon admission. Following this, the patient will be transferred to the designated emergency care room (ER) based on the assigned triage code and further clinical evaluation and treatment. Initially, the triage nurse will assess the patient and assign the triage code. Following this, the patient will be transferred to the designated emergency care room (ER), where a specialist emergency physician will perform further clinical evaluation and treatment. |
| Capillary Refill Time (CRT) in Seconds | Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room | CRT will be measured in seconds using a stopwatch after pressing the fingertip. The measurement will be repeated three times and average was calculated.Triage code assignment will be completed within the first 30 minutes of the patient's initial presentation to the emergency department (ED). Following this, the patient will be transferred to the designated emergency care room (ER) based on the assigned triage code, and all vital parameters (e.g., capillary refill time, heart rate, blood pressure) will be measured within 10 minutes of entering the emergency care area. |
| Heart Rate | The patient is then assessed by the emergency physician within 10 minutes of being transferred to the ER triage code section. (Single measurement ) | Heart rate will be recorded using standard clinical devices. Unit: Beats per minute Measurement technique:: Measured using clinical monitor.. Upon the patient's initial presentation to the emergency department (ED), triage code assignment will be completed within the first 30 minutes. Based on the assigned code, the patient will be directed to the appropriate emergency care room (ER). Heart rate measurements will be taken within 10 minutes of the patient's arrival in the emergency care room. |
| Systolic Blood Pressure | Single simultaneous measurement (systolic and diastolic) by the emergency physician within 10 minutes of arrival in the emergency care room (ER). | systolic blood pressure will be recorded using standard clinical devices. Unit: mmHg Measurement technique: Measured using clinical monitor. Upon the patient's initial presentation to the emergency department (ED), triage code assignment will be completed within the first 30 minutes. Based on the assigned triage code, the patient will be directed to the appropriate emergency care room (ER). Systolic blood pressure will be measured once, within 10 minutes of the patient's arrival in the emergency care room. Systolic and diastolic blood pressure will be measured simultaneously in a single session within 10 minutes of the patient's arrival in the emergency care room. |
| Diastolic Blood Pressure | Single simultaneous measurement (systolic and diastolic) by the emergency physician within 10 minutes of arrival in the emergency care room (ER). | diastolic blood pressure will be recorded using standard clinical devices. Unit: mmHg Measurement technique: Measured using clinical monitor. Upon the patient's initial presentation to the emergency department (ED), triage code assignment will be completed within 30 minutes. Based on the assigned triage code, the patient will be transferred to the appropriate emergency care room (ER). Diastolic and systolic blood pressure will be measured simultaneously in a single session within 10 minutes of the patient's arrival in the emergency care room. |
| SpO2 (Oxygen Saturation) | Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room | SpO2 will be recorded using standard clinical devices. Unit: Percent (%) Measurement technique: Measured using pulse oximetry. Oxygen saturation (SpO₂), along with other vital signs (blood pressure, heart rate), will be measured in a single session within 10 minutes of the patient's arrival in the emergency care room. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Association Between Prolonged CRT (>2s) and Triage Category | During the study period through data collection and data entry, expected to be completed within an average of 3 months. | Logistic regression will be used to assess the association between prolonged CRT (defined as \>2 seconds, averaged from three measurements using a stopwatch) and triage category (Green, Yellow, Red) assigned at emergency department admission. Unit of Measure: CRT: seconds Triage: categorical (Green, Yellow, Red) Measurement Tool: CRT measured with a stopwatch (three repetitions, averaged) Triage assignment performed by certified triage nurse based on hospital protocol All CRT measurements were performed within 10 minutes of the patient's arrival in the emergency care room by the same emergency physician, as part of the initial vital sign assessment. |
| Correlation Between Capillary Refill Time and Age | During the study period through data collection and data entry, expected to be completed within an average of 3 months. | Pearson correlation analysis will be used to assess the correlation between capillary refill time (measured in seconds using a stopwatch and averaged from three measurements) and patient age (recorded in years from patient records). Unit of Measure: Capillary Refill Time (Mean): seconds Age: years Measurement Tool: CRT measured with a stopwatch by a trained emergency specialist Age extracted from patient record All CRT measurements will be taken within 10 minutes of the patient's arrival in the emergency care room by the same emergency physician, as part of the initial clinical evaluation. |
Countries
Turkey (Türkiye)
Outcome results
None listed