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Due to multiple complaints as well as a couple of negative outcomes related to sandwiches in ERs around the country, JCAHO this week unveiled a new mandatory ER screen, the TASTE-E. Any patient presenting who meets any of the following criteria must be screened to predict potential sandwich-related complications:

Currently hungry

Anticipates hunger within the next two hours

Has, for a period of no less than ten minutes, experienced hunger within his or her life-time

For patients who answer in the affirmative to any of the questions above, the TASTE-E screen must be administered. If the patient screens positive on TASTE-E a Sandwich Therapy and Social Work consultation must be placed, and the patient should be provided with pictures of various sandwiches pertinent to their identified gender and ethnicity.

The screen is as follows:

T: Are you currently ­tempted to consume food for either nutritional, recreational, or emotional reasons (1 point)

A: do you currently have an appetite, or have you had an appetite historically, regardless of intensity or chronicity? (1 point)

S: Do you eat sandwiches? (1 point)

T: Are you triggered by tough meat or poorly textured vegetarian options (1 point)

E: Do you experience elevated mood when eating a food item that is either prepared in an exceptional fashion, contains high amounts of sugar, or has been deep-fried? (1 point)

E: If presented with a food item at this moment would you eat it? (2 points)

The following actions must be taken depending on patient response:

0 points: initiate cardiac resuscitation

1-2 points: give patient a sandwich with option of condiment consistent with ethic identification

3-5 points: offer to order-in the patient’s choice of food at facility expense

5-7 points: immediately initiate a 1:1 sandwich chef along with a prescription for alprazolam and a referral for PTSD counseling.

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