User:EricChau/sandbox

Article Evaluation

Evaluating Content

The Catastrophic Injury article has relevant information but has room for improvement. The page defines a catastrophic injury with a very specific definition that may not be completely agreed upon among medical professionals. The majority of the references are have been outdated, dating back over five years. Although the content is relevant, the subsection "Catastrophic injury#By activity" only includes a limited variety.

Evaluating Tone

The tone is appropriate for the article and highlights the severity of what a reasonable person would expect as catastrophic. Although the topic of the article itself is not particularly neutral in nature, the content itself does appear so, relatively speaking. The content is mainly intended to provide information and less so with presenting idealogical viewpoints.

Evaluating Sources

While the majority of the reference links work, there are a handful of links that are broken or redirect you to the Special:BookSources/ page. Of the links that do work, they are often credible and reliable. Of all the links attempted, all of them redirected me to PubMed articles.

Checking the Talk Page

There is little content in the talk page. Notably, there is another user who also highlighted the validity of the definition and its use in the field of medicine. The article is ranked as a C-Class and the reasons for so are evident. At this time, it is currently not part of any WikiProjects.

Article Selection

I have chosen to improve the Triage article. It is currently part of WikiProject Medicine/Emergency medicine and EMS task force. The article has been visited 8,570 times, as of its last update on Feb 10, 2019.

Article Evaluation

This is a B-class article rated as high-importance. The talk page dates back to 2001 and has had some activity within the last five years. There has been consistent changes to the article itself within the last five years as well. However, there are some changes within the last year which have not been discussed in the talk page.

There are several sections that need citations and also could be expanded on. More countries can be added to the conventional classifications section. The ethical implications section seems to be lacking depth. This section could include more up to date issues. Perhaps more barriers and limitations can be added and tidied-up after discussing with other users. Throughout the article, there are several areas needing references and working links. The tone and use of images are appropriate.

Potential Articles

• Safety of clinical and non-clinical decision makers in telephone triage: a narrative review
• Review article: Systematic review of three key strategies designed to improve patient flow through the emergency department
• Burn Care in Disaster and Other Austere Settings
  

Add a reference to Wikipedia

On the Triage article, I added the following citations:

• Efficacy of the Manchester Triage System: a systematic review which is citation #[33] on the Triage article.
• Safety of Clinical and Non-Clinical Decision Makers in Telephone Triage: A Narrative Review . which is citation #[18] on the Triage article.

CopyEdit

I made a few minor edits to Triage article. I simplified a few sentences and also fixed a punctuation and spelling mistake. EricChau (talk) 23:53, 19 February 2019 (UTC) 23:53, 19 February 2019 (UTC)

Article Draft of Triage

Ethical considerations

Because treatment is intentionally delayed or withheld from patients, emergency triage has ethical implications that

Since ethical implications vary between different settings and the type of triage system employed, there is often no single gold-standard approach to triage. Once triage decisions have been made, it may be difficult to evaluate afterwards whether the decisions were ethically justified and the appropriate course of action. EricChau (talk) 00:06, 22 March 2019 (UTC) This may be especially stressful for triage responders who lack experience or support from peers.

It is advised for emergency departments to preemptively plan strategies in attempts to mitigate the emotional burden on these triage responders. While doing so, standards of care must be maintained to preserve the safety of both patients and providers

Utilitarian Approach

Under the utilitarian model, triage decisions are aimed to maximize the most amount of benefits to the most amount of people possible.

During disaster scenarios, this approach is further complicated and may not be entirely possible. Using this approach implies that some individuals may likely suffer or perish in order for the majority to survive. Triage officers must allocate limited resources and weigh an individual's needs with the population as a whole. EricChau (talk) 00:58, 9 March 2019 (UTC) EricChau (talk) 01:02, 9 March 2019 (UTC)

Specific Population Groups

There is wide discussion regarding how VIPs and celebrities should be cared for in the emergency department. It is generally argued that giving special considerations or deviating from the standard medical protocol for VIPs or celebrities is unethical due to the cost of others. However, others argue that it may be morally justifiable as long as their treatment does not hinder the needs of others. When admitted these individuals, it is important to consider the overall fairness, quality of care, privacy, and other ethical implications. EricChau (talk) 00:06, 22 March 2019 (UTC)

updated:EricChau (talk) 20:16, 26 April 2019 (UTC)

Notes to Self: Thinking about removing the paragraphs regarding the history of Triage from the ethics section. (See paragraphs below). Considering whether or not to add autonomy, nonmaleficence, beneficence and justice and how it pertains to ethics during disaster triage. Will add more to VIP pragraphEricChau (talk) 00:06, 22 March 2019 (UTC)

Bioethical concerns have historically played an important role in triage decisions, such as the allocation of iron lungs during the polio epidemics of the 1940s and of dialysis machines during the 1960s. As many health care systems in the developed world continue to plan for an expected influenza pandemic, bioethical issues regarding the triage of patients and the rationing of care continue to evolve. Similar issues may occur for paramedics in the field in the earliest stages of mass casualty incidents when large numbers of potentially serious or critical patients may be combined with extremely limited staffing and treatment resources.

Research continues into alternative care, and various centers propose medical decision-support models for such situations. Some of these models are purely ethical in origin, while others attempt to use other forms of clinical classification of patient condition as a method of standardized triage. EricChau (talk) 00:58, 9 March 2019 (UTC)

EricChau's Triage Peer Review by Jkgrewal (talk) 01:19, 4 April 2019 (UTC)

Reading through your drafted edits, I can see that you have maintained a neutral tone throughout your drafts and have a large amount of credible sources backing your edits up. I will say that I didn't see a reference for the section regarding the VIPs/celebrities and the issues that arise with differential treatment. Another note I wanted to make that was just a minor error is that numbers 8 and 9 on your reference list are the same. I like how you mentioned the ethical concerns of triage in the past but I was wondering if there were some more current ethical issues that arise with triage that you may have found in your precis research. Also, after looking at the existing Triage page, I'm not sure if it is structured this way intentionally but in my opinion, I think that the lead/intro section could be edited to be made more concise and certain information could be removed and placed into a different section (i.e: history). Other than that, I can see a clear improvement from the existing page with the edits you have drafted and so far, so good!

Responding to Peer Review EricChau (talk) 18:28, 6 April 2019 (UTC)

Thanks for your feedback. I will correct the citations mentioned. After extensive searching, I found that the most recent articles regarding triage; at least in the emergency departments are all roughly within the past 10 years. This would explain why the citations listed in the actual article are also published around this timeframe. However, I was able to find a few articles published within the last 5 years that I intend on adding. I agree with your idea of keeping things up to date. In regards to the introduction, I did also notice people on the talk page with similar thoughts. Good catch. I will look into the history section and see what will make the article more fluid. Thank you!

[Note to self] + Final Draft Plans

• Add necessary and remove redundant citations
• Tidy up introduction; per seemingly general consensus among Wikipedia users
• Add more depth to ethics section
• Experiment with moving history section in terms of organization and flow of the overall article
• Add additional content if appropriate

Completed Wikipedia Article (See Below for Ethics portion)

1. Lead Section:

• Summarized major points of article with context

2. Article:

• Created History section, reorganized text to appropriate section.
• Images moved to appropriate sections

4.Ethical considerations

Because treatment is intentionally delayed or withheld from patients, triage has ethical implications that complicates the decision-making process.

Since ethical implications vary between different settings and the type of triage system employed, there is often no single gold-standard approach to triage. Once triage decisions have been made, it may be difficult to evaluate afterwards whether the decisions were ethically justified and the appropriate course of action.^[46] This can be especially stressful for triage responders who lack experience or support from peers.^[47]

It is advised for emergency departments to preemptively plan strategies in attempts to mitigate the emotional burden on these triage responders.^[48] While doing so, standards of care must be maintained to preserve the safety of both patients and providers.

Utilitarian approach

Under the utilitarian model, triage decisions are aimed to maximize the most amount of benefits to the most amount of people possible.

During disaster scenarios, this approach is further complicated and may not be entirely possible. Using this approach implies that some individuals may likely suffer or perish in order for the majority to survive. Triage officers must allocate limited resources and weigh an individual's needs with the population as a whole.^[49]

Special population groups

There is wide discussion regarding how VIPs and celebrities should be cared for in the emergency department. It is generally argued that giving special considerations or deviating from the standard medical protocol for VIPs or celebrities is unethical due to the cost of others. However, others argue that it may be morally justifiable as long as their treatment does not hinder the needs of others after assessing overall fairness, quality of care, privacy, and other ethical implications.^[50]

Added both subsections of "Utilitarian approach" and "Special Population groups"