---

Background and purpose: Waiting time to receive appropriate services in emergency departments is considered as an important indicator for evaluating hospitals. Triage is the most important and the first stage of patient’s management at the time of arrival to hospital emergency department. This study aimed at determining the length of waiting time to receive treatment and diagnostic services and related factors within 5 level triage system in Imam Khomeini Hospital in Sari. Material and Methods: This cross-sectional study was done in Imam Khomeini Hospital of Sari in December 2012. The subjects included 365 individuals who were selected through Morgan table. Waiting time for receiving treatment and diagnostic services for each patient was calculated by researcher from medical records of the patients and the triage sheet and entered in data collection forms. These forms contained two sections. The first part included demographic data and the second part contained information on the emergency department service delivery. The statistical analysis was performed in SPSS V.16 Results: The mean time of first consultant by physician was 6.4 + 7.2 mins, the mean time to receive the first nursing service was 14.9 + 14.4 mins, and the mean time to determine the patients’ status was 136.6 + 143 mins. There was a significant relation between the working shift and the mean time of first consultant by doctor and determination of the patients’ status. The same relation was also found for triage level. Conclusion: This study indicated a good level of service provided by emergency department of Sari Imam Khomeini Hospital.

---

Background and purpose: Head trauma is amongst the major causes of death and morbidity caused by traumatic injuries. Assessment of trauma patients is an active process which includes initial (triage) and secondary assessments. Various triage tools are designed and used, but, so far no specific and accurate tool has been introduced for triage of head trauma. This study compared the effectiveness of ESI triage tool and nursing triage approach based on Roy Adaptation Model to predict the need for ICU admission in patients with head trauma.
Materials and methods: A clinical trial was done in 400 patients with head trauma in Emergency Department, Mashhad Shahid Kamyab Hospital, 2016. Patients were selected using block randomization and based on the day of admission. They were allocated into receiving nursing care either through ESI triage or Roy Adaptation Model. Twelve hours after triage, patients' outcome were followed based on keeping them in ICU or ward admission. Finally, the margin of error was calculated and compared between the two instruments.
Results: Kappa test did not show any significant difference between the ESI and Roy Adaptation Model triage in prediction for ICU admission at first place (P= 0.123). But, the Roy Adaptation Model was associated with significantly less errors in keeping the patient in ICU or ward admission (P = 0.012 ).
Conclusion: Compared with ESI triage, Roy Adaptation Model could result in fewer errors in predicting the consequences of head trauma patients.