gms | German Medical Science

21st Annual Meeting of the German Retina Society and 8th Symposium of the International Society of Ocular Trauma (ISOT)

German Retina Society
International Society of Ocular Trauma

19.06. - 22.06.2008, Würzburg

Application of the RESCUE triaging system. Retrospective and prospective analysis of triaging quality

Meeting Abstract

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  • Tommaso Rossi - Rome/Italy

Retinologische Gesellschaft. International Society of Ocular Trauma. 21. Jahrestagung der Retinologischen Gesellschaft gemeinsam mit dem 8. Symposium der International Society of Ocular Trauma. Würzburg, 19.-22.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocISOTRG2008V015

The electronic version of this article is the complete one and can be found online at:

Published: June 18, 2008

© 2008 Rossi.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Purpose: Ophthalmic emergency (OE) triage is essential for prompt recognition of urgent cases. To date no formal eye-dedicated triaging system has been widely accepted. Purpose of present study is to propose a fast, accurate, and reproducible coding scale named Rome Eye system for SCoring Urgency and Emergency (RESCUE).

Design: phase I of the study is a retrospective analysis of Electronical Medical Records (EMR); phase II is a prospective consecutive series.

Participants: Phase I included 160,936 patients. Phase 2 included 1,000 consecutive patients referred to the Emergency Department of our Institution.

Methods: In phase 1 the authors retrospectively analyzed Electronic Medical Records (EMRs) of ER patients, listing signs and symptoms most frequently associated to hospitalization. Redness, pain, loss of vision and the risk for an “open eye” were identified and assigned a score ranging from 0 to 12. Colour coding was assigned based on increasing scoring: 0-3 white, 4-7 green, 8-12 yellow code. In phase 2, 1,000 consecutive ER patients were enrolled and prospectively coded according to RESCUE. After diagnosis and proper treatment, EMRs were retrospectively reviewed by a masked physician and patients re-coded (RETRO coding) according to clinical course. Correlation between RESCUE and RETRO coding was calculated.

Main Outcome Measures: Prospective and retrospective ER colour coding correlationResults: 160,936 EMR were retrospectively analyzed; 2,407 (1.4%) patients required hospitalization. Loss of vision (90%), redness (76%) and pain (47%), were the most frequent complaints. RESCUE significantly correlated to RETRO coding (p<0.01): 841/1,000 patients coded exactly the same colour, 45/1,000 have been overestimated by 1 colour class, none by 2, 107/1,000 underestimated by 1 and 6/1,000 by 2 classes. The 32/1,000 hospitalized patients in the prospective cohort had a RESCUE score significantly higher than non-admitted patients (p<0.01) and colour coding among admitted and dismissed patients was significantly different as well (p<0.01).