[Current trends in emergency triage in Taiwan: the five-level triage system].

An ideal triage system should accurately and quickly sort patients according to seriousness of diseases, and ensure that patients in emergency departments (EDs) get adequate management in an appropriate medical environment. Recently, EDs throughout the world have been confronting overcrowding, and are developing a five-level triage system to solve the problems that this presents. Taiwan EDs have used the Taiwan triage system (TTS) since 1999 until recently. In order to follow the trend of the times, EDs in Taiwan adjusted the four-level TTS to a five-level system, and built a computer system which is reliable and effective. This article reviews the literature about emergency triage systems, and describes the differences between the four-level and five-level systems, exploring the reliability, effectiveness, and outcomes of triage systems. Taiwan nurses might treat this article as a basis for reflection on the importance of the five-level triage system.

[Family satisfaction with systematic nursing instructions in a pediatric emergency department].

This study aimed to evaluate satisfaction with systematic nursing instructions among family members of pediatric emergency patients and to determine the degree to which family members complied with instructions provided. All subjects recruited were from a single medical center. A structured questionnaire was used to collect data. Written systematic nursing instructions were given to patient family members, supplemented by verbal interpretation. Family members were then contacted by telephone at 24 and 72 hours, respectively, after emergency department (ED) discharge. Questionnaires were completed and mailed back to the hospital within 72 hours. The 362 valid responses returned out of 700 questionnaires dispensed represented a response rate of 51.7%. Data were analyzed using descriptive statistics, t-test, one-way ANOVA and Scheffe's test. Main study findings included: (1) Family member satisfaction with systematic nursing instructions was 83.8%; (2) Families with higher educational levels had higher expectations in terms of health education and were less satisfied with instructions provided; and (3) 61.4% of participants reported symptom relief after following systematic nursing instructions and, as a result, did not need to return for further clinical help. Results demonstrate that systematic nursing instructions are effective in improving family satisfaction and compliance with nursing instructions. In addition, these instructions help reduce the rate of unplanned return visits to the pediatric ED.

The construction, characterization and transfection of liposome- polycation-CDKN1B plasmid complexes.

OBJECTIVE: To develop an efficient non-viral gene delivery system in order to transfer CDKN1B gene efficiently into lung and liver carcinoma cells. METHODS: A recombinant plasmid composed of CDKN1B sequence and EYFP as reporter gene was constructed and identified. The recombinant DNA was then formulated the lipids-polycation-DNA complexes(LPDs) with protamine sulfate. Several kinds of lung and liver carcinoma cells were transfected by means of LPDs. The physicochemical properties of LPDs were investigated using PCS method and TEM, respectively. The expression of EYFP in A549 cells was observed under fluorescent microscope and evaluated by flow cytometry analysis. Finally, the production of CDKN1B protein in transfected LLC, Chang and 7721 cells was identified by Western blot analysis. RESULTS: The average diameter of the LPDs were 167 nm with the polydispersity index of 0.35. The average zeta potential of LPDs was +32.6 mV. LPDs look like a sunken sphere. The fluoresent microscope picture clearly indicated the expression of EYFP in A549 cells. The flow cytometry result showed that the transfection efficiency of LPDs in A549 cells was comparable with that of LipofectAMINE, the positive control. Western blot analysis confirmed the production of CDKN1B protein in LLC, Chang and 7721 cells transfected with LPDs, while no CDKN1B protein was detected in cells transfected with naked DNA. CONCLUSION: The construction of the recombinant plasmid is successful. LPDs can deliver the recombinant plasmid to lung carcinoma cells and liver carcinoma cells with high efficiency. Therefore, this kind of gene delivery system has the potential uses for the treatment of lung and liver cancer.