ed triage
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CLEVELAND, OH – A recent multi-center observational trial involving several EDs in Cleveland have demonstrated that texting on one’s cell phone during an initial ED triage interview results in markedly improved clinical outcomes.  The increasing ubiquity of cell phones among the population at these EDs have led some experts to claim that positive health outcomes are poised to soar among this frequently underserved cohort in subsequent years.

ed triageThe design of the study was as follows: 5000 consecutive patients aged 12-60 who presented to an ED were enrolled in this prospective observational trial.  Of these 5000, 850 of them were found to be texting on their cell phone for at least 10 seconds some time during the ED triage interview.  All patients were followed throughout their ED and hospital course, if applicable.

The results were surprising.  Of the 850 patients who texted on their cell phone, all 850 were either discharged from the ED or admitted for 24 hours or less without a remotely serious medical or surgical condition being diagnosed.  Among the 4150 controls who did not text on their cell phone, 18.4% (95% CI 14.5%-21.2%, p<0.05) ended up being admitted for more than 24 hours and 14.2% (95%CI 13.1%-15.0%, p<0.05) were diagnosed with a condition defined as “very serious or life-threatening.”

In the discussion section of the paper, the authors have a number of theories to explain this apparent correlation.

What they consider the most plausible theory is that the hand movement and cognitive function associated with texting must provide a therapeutic feedback loop to the brain resulting in a dopamine surge promoting instant healing.  Another theory is that instead of texting, these patients are actually setting up YouTube to watch an episode of Dr. Oz (which we all know has healing powers).  A further assertion is that users of their cell phones may be texting another medical provider for advice.

A final conjecture was that the phrases themselves may have healing powers.  With consent of a subgroup of patients, analysis of the text messages was undertaken which showed a certain unspecified code was being used to communicate between users.  A few examples of these utterances include lol, rotfl, omg, smh, and fml.  Further studies will be needed to investigate the possible therapeutic potential of these phrases.

This study has engendered some controversy.  One far-fetched and ludicrous claim by jealous academic know-it-alls is that there should have been a baseline comparison analysis between the texting-on-cell-phone group and the control group, as this may have led to a radical concept called, “selection bias.”  It is notable that this possibility was considered but not analyzed in the study due to the fact the study author and author of this article wasn’t really paying attention when that… um…. part was discussed in their meeting because he was… uh… busy playing Words With… Friends on his, um, cell… thingie.  Woo hoo!  Triple Word Score!

If you enjoyed this article, please check out the author’s website First World Emergency Medicine for other great articles.

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  • Robyn Ayers

    I’ve also found that eating flaming hot Cheetos in the waiting room helps to ease ABD pain.

  • Cheryl Ray Strahm

    My daughter was able to text barely out of anesthesia.

  • Lesley TheBrit

    I love Gomerblog

  • Catherine Carter

    I’m dying!! But first. Lemme take a selfie.

  • Mike Cummings

    Well, she looked VERY healthy to me. The wonders of medicine – or was she the ER Triage nurse?

  • Stefanie Avery

    Kt Simpson

  • Pam AndTroy Yates

    Omgosh!!! I charted just to that affect while working in triage today. Not only texting but answering and talking on the phone

  • Angela Chabert Mathieu

    Jennifer Holscher Ryan

  • Donna Miller

    Jenny Flanagan Carnagey

  • Valerie Bazar

    When I’m in triage I hang a poster that reads “When you’re done using your phone I’ll be happy to help you.” Still trying to figure out how to translate my sign into Spanish…

  • Gina Cotton Simpson

    How about texting with a Mountain Dew and bag of Cheetos held between the thighs?

  • David Andrew

    Pain is 10/10 but I still have perfect manual dexterity and state of mind to text.

  • David Andrew

    Pain is 10/10 but I still have perfect manual dexterity and state of mind to text.

  • Jamie Christopoulos Sweeney

    But I have found a negative outcome when texting during pelvic exams..usually they get some antibiotics

  • Jamie Christopoulos Sweeney

    But I have found a negative outcome when texting during pelvic exams..usually they get some antibiotics

  • Lori Drake

    I love sending the pts home that came in with a suitcase!!

  • Lori Drake

    I love sending the pts home that came in with a suitcase!!

  • Kim Hardy

    Could it POSSIBLY be that if they are feeling up to texting, then they’re not that sick to begin with?

  • Greg Conner

    I tend to be more crass and just say “you need to get off your phone”. I’m an ER physician who works in multiple states…I’m about sick of it…

  • Greg Miller

    When the phone comes out during triage I walk out of the room to give them their private then come back after 15 minutes, if they are still texting or talking I tell them ill come back to finish my triage when they are ready for me to deal with their emergency. This usually works. If not I keep getting mini breaks.

  • Silvana Bonilla

    lol!!!

  • Leigh Anne Spofford Fraser

    Ah “positive luggage sign” is a serious thing

  • Ron Allen

    I think I know why they are a healthier group-they have no discernible illness to begin with!!!

  • Andrèa Migneault

    Lmao

  • Preston Luke

    I think the “study” left out the possible explanation that most patients who are texting at triage are less critical and less emergent to begin with. Many patients with true emergencies and/or pain do not feel well enough to text.

  • Jacob Kuriakose

    They need to do the same study correlating ED outcomes with patients who show up with either a teddy bear or a suitcase.

  • Yasmina Garcia

    I had a pt texting during moderate sedation,while we were trying to pop that shoulder back..lol

  • Jacki Nee-Gasaway

    I’m thinking this could possibly be the effect of the cherry koolaide IV the triage attendant gave her over the texting.

  • Chelie Harrell

    Lisa Lisa Susan Oliver

  • Sarah Baker

    I think being unable to text (in under 30 yo pts) should be a triage modifier – inability to text = up one level of acuity

  • Courtney Stine

    The worst are the parents who take selfies with their sick kids. Gotta get that Facebook sympathy somehow!

  • Susan Ermer

    Waiting to see the doctor, LOL!!

  • Rachel Carty Moehlmann

    Meaghan Fleschner Barry

  • Rachel Carty Moehlmann

    Meaghan Fleschner Barry

  • Lisa Barber

    Had a patient laying with his head slightly elevated and texting busily while spitting occ. his mother thought he was dying of epiglottitis..She was hysterical.

  • Lisa Barber

    Had a patient laying with his head slightly elevated and texting busily while spitting occ. his mother thought he was dying of epiglottitis..She was hysterical.

  • James Uthe

    My pain is a 10, hold on I have to text this picture.

  • James Uthe

    My pain is a 10, hold on I have to text this picture.

  • Caitlin Dwyer McDonnell

    But boy do they get mad when you say “I don’t want to interrupt you, so I’ll move onto the next person while you finish your conversation”.

  • Caitlin Dwyer McDonnell

    But boy do they get mad when you say “I don’t want to interrupt you, so I’ll move onto the next person while you finish your conversation”.

  • Kimberly Miller Grabel

    A local hospital is offering a “check out” system for chargers. Like a library. smh.

  • Kimberly Miller Grabel

    A local hospital is offering a “check out” system for chargers. Like a library. smh.

  • Mary Wehmeier

    Kim… Sonya – Another day at the office!

  • Mary Wehmeier

    Kim… Sonya – Another day at the office!

  • Maria Nikolova-Ovcharov

    :) )))

  • Maria Nikolova-Ovcharov

    :) )))

  • Maria Nikolova-Ovcharov

    :) ))))

  • Maria Nikolova-Ovcharov

    :) ))))

  • Mary Auger Houston

    Hahaha! I think I would theorize that these patients have positive outcomes because they weren’t really that sick to begin with.

  • Mary Auger Houston

    Hahaha! I think I would theorize that these patients have positive outcomes because they weren’t really that sick to begin with.

  • Aimee Wilde

    Serious? How annoying!

  • Aimee Wilde

    Serious? How annoying!

  • Zehra Heisenberg

    Carra Brandley Aimee Wilde

  • Zehra Heisenberg

    Carra Brandley Aimee Wilde

  • Ryan Pettit

    Brittany Isom Desi Kyriakopoulos Cordell Dave Kritner Andrea Walls Harrell Jennifer Ryder Medlin Chrystal Guiles Martin Shae Mosley Colton Fortner

  • Ryan Pettit

    Brittany Isom Desi Kyriakopoulos Cordell Dave Kritner Andrea Walls Harrell Jennifer Ryder Medlin Chrystal Guiles Martin Shae Mosley Colton Fortner

  • Nate Schneider

    Billie Jo Grieve

  • Nate Schneider

    Billie Jo Grieve

  • Douglas Dew

    So should the ER provide free cell phone chargers when the wait time exceeds battery like or is there a “charge” for that? Guess we might need an ICD-10 code for texting in ER also.

  • Warwick Low

    “I might die from this gun shot but first, a selfie!”

  • Saad Mohammad

    Fareen Zaver

  • Victoria Morgan

    Had a patient who got shot in the trauma bay couldn’t hardly participate in his own triage because he was texting through a fight with his girlfriend who didn’t believe he was shot.

  • Greg Eck

    Though I did have a PT who had been shot, texting calmly at the desk

  • Callie Kilpatrick

    All day every day. The life of a triage nurse.

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