(1) From the complementary dialogue between the principle-based approach and the care-oriented approach, we can conclude that a clinically and ethically based ED triage process is not only based on a momentary decision made by one person. It also takes relevant ethical principles as respect for autonomy, nonmaleficence, beneficence, and justice into account, as well as the fact that triage is a part of dynamic care process incorporating

the four dimensions of care. (2) Based on the essential importance of a supportive institutional framework, Inhibitors,research,lifescience,medical it is essential to opt for a hospital-wide strategy of triage planning with a broad involvement of relevant people. Hospital management, ED management and staff, triage officers, directors and staff of other departments are important stakeholders in the process [3,10]. As triage involves significant moral implications, it is

important to involve public representatives and ethics scholars in the development of institutional Inhibitors,research,lifescience,medical ethics policies on triage planning [10]. (3) Just as triage itself is a dynamic process, and in itself part of the dynamic process of overall patient care, it is important to consider triage planning as a phenomenon that is susceptible to change. Hence, it is important to carry out regular reviews of the hospital’s ED triage protocol, based Inhibitors,research,lifescience,medical on experiences of staff and patients, and on evolutions in care [10]. Proposed revisions of the protocol could then be reviewed and selleck kinase inhibitor evaluated by multidisciplinary task forces, hospital ethics committees, or by organizations of emergency medicine and nursing professionals, according to its compliance with the comprehensive Inhibitors,research,lifescience,medical ethics perspective that incorporates both the above-described principles and care-oriented approach. (4) ED staff has to operate in highly stressful, ethically sensitive, and sometimes even traumatic circumstances. Providing sufficient support on educational (communication, stress and aggression management), psychological (feedback)

Inhibitors,research,lifescience,medical and ethical level, is essential for realizing a clinical-ethical based process of triage planning. A good and supportive hospital culture is a crucial determinant for this. As such, the various ethical aspects that are intrinsically related to ED triage, and which we have identified by our ethical analysis, can help to create a CYTH4 supportive clinical-ethical framework for ED triage. Abbreviations ACEM: Australasian College for Emergency Medicine; ATS: Australasian Triage Scale; CTAS: Canadian Triage and Acuity Scale; ED: Emergency Department; ESI: Emergency Severity Index; LSI: Life Saving Interventions; SALT: Sort, Assess, Life-saving interventions, Treatment and/or transport; SARS: Severe Acute Respiratory Syndrome; SORT: Strategy for Off-Site Rapid Triage; START: Simple Triage and Rapid Treatment; Competing interests The authors declare that they have no competing interests.