Authors: (including presenting author): :
Chan MH(1), Lau TL(1), Ma Bryan(1), Wong NK(1), Wong WY(1), Chu SW(1)
Affiliation: :
(1) Accident and Emergency Department, Kwong Wah Hospital
Keyword 1: :
young adults
Keyword 5: :
emergency department
Introduction: :
Young adult stroke and transient ischemic attack (TIA) are rising globally and locally, yet young patients often present with atypical symptoms such as dizziness and headache that are easily missed by conventional tools like FAST in busy Accident and Emergency Department (AED) triage. This practice gap contributes to under-triage, treatment delay, and suboptimal neurological outcomes for 18–50-year-old patients in a high-demand emergency setting. A standardized, evidence-based triage approach tailored to atypical presentations is needed to enhance early recognition and timely intervention
Objectives: :
The project aimed to: 1. Implement a standardized assessment tool using the TriAGe+ scoring system for young adult stroke/TIA at AED triage. 2. Enhance triage nurses’ knowledge and confidence in recognizing atypical stroke presentations. 3. Improve triage accuracy of young adult stroke/TIA cases.
Methodology: :
A quality enhancement program is planned in the AED to improve triage screening for young adults (18–50) with suspected stroke/TIA using the TriAGe+ score. It comprises four phases: literature review, adaptation of the TriAGe+ score into the triage stage, staff training, and evaluation. A 30-minute small group workshop covering stroke epidemiology, symptoms and risk factors, use of the TriAGe+ score and case scenarios was delivered. Approximately 15-20 AED nurses with varying experience levels will be invited to participate. For the clinical audit, convenience sampling of consecutive eligible triage records will be used. All patients aged 18–50 years who present during the audit periods with a chief complaint of dizziness, vertigo, or suspected stroke/TIA will be screened. The cases meeting these criteria will be included until approximately 20 records are obtained in the pre‑implementation phase and 20 records in the post‑implementation phase.
Result & Outcome: :
The project is expected to increase triage nurses’ knowledge and confidence in recognizing both typical and atypical stroke/TIA symptoms in young adults. A post-training test would show improved test scores and higher self-rated confidence compared with baseline. Application and implementation of the evidence-based nursing practice, TriAGe+ guide, are anticipated to support the nurses with more consistent triage decision-making and earlier activation of appropriate stroke pathway for high risk young adults. Audit findings are intended to demonstrate better alignment between clinical presentations, TriAGe+ scores and triage categories, supporting the incorporation of the TriAGe+ guide and training session into AED ongoing education.
