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FRANCIS M. FESMIRE, MD
Chattanooga, Tenn

ROBERT F. PERCY, MD; ROBERT L. WEARS, MD; TERRY L. MACMATH, MD
Jacksonville, Fla

Arch Intern Med. 1990;150(4):921.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—We appreciate the comments of Dr Burnside; however, we feel that the thrust of his arguments is misdirected. Our triage algorithm assumes, as have others, ^1-5 that only patients with life-threatening complications clearly benefit from intensive care unit monitoring. Of the 57 low-risk patients, seven patients had four interventions, five non-life-threatening complications, and two myocardial infarctions. No intervention was emergent, and no life-threatening complication occurred in this group. Furthermore, of the two patients diagnosed as having an acute myocardial infarction, both had normal electrocardiograms on presentation, with only nondiagnostic ST-T changes appearing on serial electrocardiograms. Thus our low-risk group has a false-negative rate of 0% and not the 10% as stated in Dr Burnside's letter. While we agree that should the data be extended, life-threatening complications and/or death will ultimately occur in the low-risk group, the results to date indicate that this risk will be small.

Dr Burnside's . . . [Full Text PDF of this Article]

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