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61-615: Henri Negresco, born Alexandru Negrescu, was the son of an innkeeper. He was educated in Romania and began his professional career as a confectioner at the renowned Casa Capșa in Bucharest . At the age of 25—though some earlier sources suggest 15, which seems unlikely given that he completed military service in Romania and there is photographic evidence of him in Bucharest at an older age—Negresco left Romania. He first moved to Paris and later settled on

122-399: A mass casualty incident ), or when there are more injured individuals than supplies to treat them. The methodologies of triage vary by institution, locality, and country but have the same universal underlying concepts. In most cases, the triage process places the most injured and most able to be helped as the first priority, with the most terminally injured the last priority (except in

183-484: A disaster uses a multi-tier scale: This triage is performed by a physician called médecin trieur (sorting medic). The German triage system uses four color codes: In Hong Kong , triage in Accident & Emergency Departments is performed by experienced registered nurses , patients are divided into five triage categories: Critical , Emergency , Urgent , Semi-urgent and Non-urgent . In mass casualty incidents,

244-573: A form of secondary triage, where the evaluation occurs at a secondary location like a hospital, or after the arrival of more qualified care providers. There are a three primary concepts referred to as Reverse Triage. The first is concerned with the discharge of patients from hospital often to prepare for an incoming mass casualty. The second concept of Reverse Triage is utilized for certain conditions such as lightning injuries, where those appearing to be dead may be treated ahead of other patients, as they can typically be resuscitated successfully. The third

305-694: A literary reputation by reading one's texts there. Actors also were among the regulars: at the time the Romanian National Theatre was nearly across the street, adjacent to the Terasa Oteteleșanu, now the site of the Bucharest Telephone Palace . When the Romanian Communist Party took power in 1948, they closed Casa Capșa. The restaurant operated during most of the communist era as the "Bucharest Restaurant", regaining

366-512: A neighborhood. Without proper personal protective equipment, more than 253 residents were evacuated and 50 were hospitalized. 20 vehicles were called to the scene, and a mobile operating center was setup nearby, likely within the zone of contamination. Unaware of the presence of Sarin, triage was performed following the standard system of the time, which ultimately resulted in eight care givers experiencing mild sarin poisoning, and an unknown amount of additional staff experiencing general malaise. At

427-426: A permanent hospital, more advanced care was provided at each stage, and the mindset of treating only what was absolutely necessary fell away. Although triage almost certainly occurred in the days after the atomic bombings of Hiroshima and Nagasaki , the pandemonium caused by the attack left records of such action non-existent until after the fifth day, at which point they are largely without historical use. In 1947,

488-719: A secondary or tertiary care facility to survive, those who require low-intensity care to survive, those who are uninjured, and those who are deceased or will be so imminently. In the United States, this most commonly takes the form of the START triage model, in Canada, the CTAS model, and in Australia the ATS model. Assessment often begins with asking anyone who can walk to walk to a designated area, labeling them

549-588: A wider applicability, as some conditions which may be survivable outside of extreme circumstances become unsurvivable due to the nature of a mass casualty incident. For these patients, as well as those who are deemed to be unsavable, palliative care can mean the difference of a painful death, and a relatively peaceful one. During the COVID-19 pandemic issues of palliative care in triage became more obvious as some countries were forced to deny care to large groups of individuals due to lack of supplies and ventilators . In

610-487: Is a historic restaurant in Bucharest , Romania , first established in 1852. At various times it has also included a hotel; most recently, it reopened as a 61-room hotel 17 June 2003. "...long a symbol of Bucharest for its inhabitants... Capșa is not only associated with its exquisite pastry products, but also for a hectic literary life of yore... a welcoming place for Romanian writers where they could meet, talk and...associate." The restaurant stands on Calea Victoriei at

671-401: Is a process by which care providers such as medical professionals and those with first aid knowledge determine the order of priority for providing treatment to injured individuals and/or inform the rationing of limited supplies so that they go to those who can most benefit from it. Triage is usually relied upon when there are more injured individuals than available care providers (known as

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732-410: Is less likely to occur when triaging is performed by hospital medical teams, rather than paramedics or EMTs. In telephone triage, care providers like nurses assess symptoms and medical history, and make a care recommendation over the phone . A review of available literature found that these services provide accurate and safe information about 90% of the time. In triage, palliative care takes on

793-571: Is not immediately obvious, it is used in any patient who appears to be a child (patients who appear to be young adults are triaged using START). In hospital settings, Australia and New Zealand rely on the Australasian Triage Scale (abbreviated ATS and formally known as the National Triage Scale ). The scale has been in use since 1994. The scale consists of 5 levels, with 1 being the most critical (resuscitation), and 5 being

854-472: Is rapid patient assessment designed to check bodily function in order of importance. A triage tag is a premade label placed on each patient that serves to accomplish several objectives: Triage tags take a variety of forms. Some countries use a nationally standardized triage tag, while in other countries commercially available triage tags are used, which vary by jurisdictional choice. In some cases, international organizations also have standardized tags, as

915-757: Is the case with NATO . The most commonly used commercial systems include the METTAG, the SMARTTAG, E/T LIGHT and the CRUCIFORM systems. More advanced tagging systems incorporate special markers to indicate whether or not patients have been contaminated by hazardous materials, and also tear off strips for tracking the movement of patients through the process. In advanced triage, those with advanced training, such as doctors, nurses and paramedics make further care determinations based on more in-depth assessments, and may make use of advanced diagnostics like CT scans . This can also be

976-476: Is the concept of treating the least injured, often to return them to functional capability. This approach originated in the military, where returning combatants to the theatre of war may lead to overall victory (and survivability). Undertriage is underestimating the severity of an illness or injury. An example of this would be categorizing a Priority 1 (Immediate) patient as a Priority 2 (Delayed) or Priority 3 (Minimal). The rate of undertriage generally varies by

1037-580: The Battle of Bucharest and the occupation of the city by the Central Powers , the restaurant was requisitioned by troops of the Kingdom of Bulgaria 's army . Reportedly, these left the place in a deplorable condition for an extended period of time. Casa Capșa invented the all- chocolate Joffre cake in honor of a visit to Romania by Joseph Joffre after the war, and they were the first to introduce ice cream to

1098-586: The French Riviera , where he found considerable success. As director of the Municipal Casino in Nice, he had the idea to build a sumptuous hotel of quality that would attract the wealthiest of clients. After arranging the financing, he hired the great architect of the "café society" Édouard-Jean Niermans to design the hotel and its now famous pink dome. The spectacular Baccarat 16,309-crystal chandelier in

1159-533: The German forces . Once at a casualty clearing station, wounds were dressed, and anyone requiring immediate surgical intervention was placed in a cart and brought immediately to an ambulance pickup area. If the wounded could wait, they would be evacuated by ambulance during the night. Ambulances, driven by YMCA and American Red Cross trained drivers then removed the casualties to mobile surgical centers , called postes avances des hospitaux du front or outposts of

1220-627: The Hôtel Café Anglais in Paris . In 1908, the British magazine John Bull ranked it "among the best hotels in the world". According to the revived hotel's web site, "It was considered for a long time the only suitable residence of the artists, rich and aristocratic families or high rank politiciens [sic] and diplomats visiting Romania," a role it would eventually yield to the Athénée Palace . Among

1281-838: The START triage system is used. In Japan , the triage system is mainly used by health professionals. The categories of triage, in corresponding color codes, are: All public hospitals in Singapore use the Patient Acuity Category Scale (PACS) to triage patient in Emergency Departement. PACS is a symptom-based differential diagnosis approach that triages patients according to their presenting complaints and objective assessments such as vital signs and Glasgow Coma Scale, allowing acute patients to be identified quickly for treatment. PACS classifies patients into four main categories: P1, P2, P3, and P4. In mass casualty incidents,

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1342-587: The Surgeon in Chief of Napoleon's Imperial Guard laid the groundwork for what would eventually become modern triage introducing the concept of "treat[ing] the wounded according to the observed gravity of their injuries and the urgency for medical care, regardless of their rank or nationality". Simple triage is usually used in a scene of an accident or " mass-casualty incident " (MCI), in order to sort patients into those who need critical attention and immediate transport to

1403-855: The Texas City Disaster occurred when the SS Grandcamp exploded in Texas City, Texas , killing 600 people and injuring thousands more. The entire fire department was killed in the blast, and what followed was a massive informal triage of the victims. Drug stores, clinics, and homes were opened as makeshift triage stations. As the city has no hospital, they had to evacuate casualties to area facilities, including those in Galveston and Houston , with at least one doctor relying on skills he had learned in World War II to inform care decisions. The Korean War saw

1464-570: The Canadian Triage and Acuity Scale (CTAS), which is used across the country to sort incoming patients. The system categorizes patients by both injury and physiological findings, and ranks them by severity from 1–5 (1 being highest). The model is not currently used for mass casualty triage, and instead the START protocol and METTAG triage tags is used. In France , the Prehospital triage in case of

1525-501: The Capșa name in 1984. It was at the Capșa that the poet Nicolae Labiș stood up in November 1956 and loudly recited Mihai Eminescu 's banned patriotic poem "Doina"; a few weeks later, after spending some time at the Capșa, Labiș was fatally hit by a tram, just a short distance away. The In Your Pocket guide series describes it as having been "...the chosen venue for the beautiful people at

1586-527: The Edwin Smith Papyrus contains descriptions of the assessment and treatment of a multitude of medical conditions, and divides injuries into three categories: During the reign of Emperor Maximilian I , during wartime, a policy was implemented where soldiers were prioritized over all others in hospitals, and the sickest soldiers received treatment first. Modern triage grew out of the work of Baron Dominique-Jean Larrey and Barron Francois Percy during

1647-512: The Hotel Negresco was listed by the government of France as a National Historic Building and is a member of Leading Hotels of the World . In total, the Hotel Negresco has a total of 119 guest rooms plus 22 suites. The fifth floor of the hotel is for "VVIP" guests, which stands for "very, very important persons". The hotel has a private beach, which is located across the street from the facility. In

1708-662: The Negresco's Royal Lounge was commissioned by Czar Nicholas II , who due to the October Revolution was unable to take delivery. Contrary to popular belief, the large window of the Royal Lounge – listed as an Historical Monument – is not the work of Gustave Eiffel . Eiffel never worked at the Negresco; instead it is entirely the work of Edouard-Jean Niermans. Henri Negresco faced a downturn in his affairs when World War I broke out two years after he opened for business. His hotel

1769-507: The Trauma and Injury Severity Score, the latter of which has been shown to be most effective at determining outcome. S.T.A.R.T. (Simple Triage and Rapid Treatment) is a simple triage system that can be performed by lightly trained lay and emergency personnel in emergencies. It was developed at Hoag Hospital in Newport Beach, California for use by emergency services in 1983. Triage separates

1830-479: The United States directly. The fact that the U.S. was no longer seen as untouchable, along with the later Oklahoma City bombing in 1995, and the September 11th attack lead to long term changes in triage practices to be more focused on operational safety and the risk of secondary attacks designed to kill care providers. In June 1994, emergency crews began responding to calls related to symptoms of toxic gas exposure in

1891-500: The advent of the tiered triage, wherein care providers sorted people into categories defined ahead of time. These categories, immediate, delayed, minimal and expectant are still the basis for most triage systems today. The time period was also marked by improvements in medical understanding, including shock, which allowed effective interventions to be administered earlier in the Triage process, which in turn significantly improved outcomes. At

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1952-448: The care of large numbers of patients, or are places that could be so set up. Examples include schools, sports stadiums, and large camps that can be prepared and used for the care, feeding, and holding of large numbers of victims of a mass casualty or other type of event. Such improvised facilities are generally developed in cooperation with the local hospital, which sees them as a strategy for creating surge capacity. While hospitals remain

2013-656: The case of reverse triage). Triage systems vary dramatically based on a variety of factors, and can follow specific, measurable metrics, like trauma scoring systems , or can be based on the medical opinion of the provider. Triage is an imperfect practice, and can be largely subjective, especially when based on general opinion rather than a score. This is because triage needs to balance multiple and sometimes contradictory objectives simultaneously, most of them being fundamental to personhood: likelihood of death, efficacy of treatment, patients' remaining lifespan, ethics, and religion. The term triage comes directly from French , where

2074-462: The concepts created during the Korean War. Advances in helicopters allowed the introduction of the first helicopter medics, who were able to provide fluid resuscitation , and other interventions mid-flight. This made it so that the average time from injury to definitive care was less than two hours. This evolution also flowed into the everyday life, with air ambulances emerging in the civilian world by

2135-592: The corner of Edgar Quinet Street, across from the Hotel Capitol and diagonally across from the Palace of the National Military Circle . In 1852, Anton and Vasile Capșa founded the first confectionery shop on Calea Victoriei, somewhat north of the present Casa Capșa, which was founded by their younger brother Grigore Capșa (1841-1902) in 1868. Anton and Vasile had financed Grigore through four years of courses at

2196-435: The country. The coffee house, established 1891, was an important literary and artistic gathering place, but never turned a profit, "because the writers and artists who went there usually ordered mineral water and coffee and made them last for hours on end." In contrast to the elegant restaurant and confectioner, the coffee house had simple, uncovered wooden tables. Tudor Arghezi referred to it as an "Academy"; one could make

2257-407: The field, evacuation of all casualties is the ultimate goal, so that the site of the incident can ultimately be cleared, if necessary investigated, and eventually rendered safe. Additional considerations must be made to avoid overwhelming local resources, and in some extreme cases, this can mean evacuating some patients to other countries. Alternative care facilities are places that are set up for

2318-496: The field. Moreover, the recent development of new machine learning methods offers the possibility to learn optimal triage policies from data and in time could replace or improve upon expert-crafted models. Most simply, the general purpose of triage is to sort patients by level of acuity to inform care decisions; so that the most people possible can be saved. Although a multitude of systems, color codes, codewords, and categories exist to help direct it, in all cases, triage follows

2379-402: The frontline hospitals. At the mobile surgical hospitals, the most severe cases were treated, specifically those who were likely to die before reaching a permanent, more equipped hospital. Anyone who could survive the trip was transported to a farther away, often costal, hospital. Upon reaching a permanent hospital, casualties received appropriate care to treat all of their injuries. By

2440-713: The hotel also offers gourmet dining at the Regency-style Le Chantecler restaurant. Le Chantecler has two stars in the Guide Michelin and 15/20 in Gault Millau . It has previously been under the leadership of famous chefs such as Bruno Turbot and Alain Llorca, who left to take over the equally fabled Moulin de Mougins . The restaurant interior is decorated with gobelins and roccoco furniture in untraditional colourings such as pink, lime, lemon, and cerulean. In 2003,

2501-491: The hotel with luxurious decorations and furnishings, including an outstanding art collection and rooms with mink bedspreads. She also popularised it with celebrities; Elton John featured it in the video for his song " I'm Still Standing ", and she told Bill Gates , the founder of Microsoft , that purchasing it would be beyond his means. Noted for its doormen dressed in the manner of the staff in 18th-century elite bourgeois households, complete with red-plumed postilion hats,

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2562-777: The hotel's guests in its heyday were German Kaisers Wilhelm I and Wilhelm II ; Austro-Hungarian emperor Franz Josef I ; several members of the Imperial Russian royal family, including Tsar Alexander II ; all four Romanian monarchs and their queens consort; kings of Greece , Serbia , and Bulgaria ; and such other notables as Josephine Baker , Sarah Bernhardt , Enrico Caruso , George Enescu , Paul Morand , W. Averell Harriman , Józef Piłsudski , and Raymond Poincaré . 44°26′7.90″N 26°5′53.07″E  /  44.4355278°N 26.0980750°E  / 44.4355278; 26.0980750 Triage In medicine, triage ( / ˈ t r iː ɑː ʒ / , / t r i ˈ ɑː ʒ / )

2623-456: The injured into four groups: Triage also sets priorities for evacuation and transport as follows: The JumpSTART pediatric triage MCI triage tool is a variation of the S.T.A.R.T. model. Both systems are used to sort patients into categories at mass casualty incidents (MCIs). However, JumpSTART was designed specifically for triaging children in disaster settings. Though JumpSTART was developed for use in children from infancy to age 8, where age

2684-534: The least critical (nonurgent). In field settings, various standardized triage systems are used, and there is no area wide standard. In 1995, the CAEP Triage and Acuity scale was launched in Canada relying on a simplified version of the Australian National Triage Scale. This scale used three categories, emergent, urgent, and non-urgent. This scale was deprecated in 1999 with the introduction of

2745-579: The location of the triage, with a 2014 review of triage practices in emergency rooms finding that in-hospital undertriaging occurred 34% of the time in the United States, while reviews of pre-hospital triage finding undertriage rates of 14%. Overtriage is the overestimating of the severity of an illness or injury. An example of this would be categorizing a Priority 3 (Minimal) patient as a Priority 2 (Delayed) or Priority 1 (Immediate). Acceptable overtriage rates have been typically up to 50% in an effort to avoid undertriage. Some studies suggest that overtriage

2806-524: The lowest priority, and assessing other patients from there. Upon completion of the initial assessment by the care provider, which is based on the so-called ABCDE approach , patients are generally labelled with their available information, including "patient’s name, gender, injuries, interventions, care-provider IDs, casualty triage score, and an easily visible overall triage category". An ABCDE assessment (other variations include ABC, ABCD, ABCDEF, and many others, including those localized to non-English)

2867-470: The mid-1960's. The use of triage in emergency departments and ambulance services also quickly followed. In 1993, the north tower of the World Trade Center was bombed , in a plot with a similar intended outcome as the later September 11th attacks . While search, rescue and triage operations immediately following were ordinary, the attack itself represented one of the first terrorist attacks affecting

2928-510: The onset of World War II, American and British forces had adopted and adapted triage, with other global powers doing the same. The increased availability of airplanes allowed rapid evacuation to a hospital outside of the warzone to become a part of the triage process. Although the basic practices remained the same as in World War I, with initial evacuation to an aid station, followed by transitions to higher levels of care, and eventual admission to

2989-462: The preferred destination for all patients, during a mass casualty event such improvised facilities may be required in order to divert low-acuity patients away from hospitals in order to prevent the hospitals becoming overwhelmed. The general concept was first described in a 17th-century BCE Egyptian document, the Edwin Smith Papyrus . Discovered in 1862, outside of modern-day Luxor, Egypt ,

3050-421: The reign of Napoleon . Larrey in particular introduced the concept of a "flying ambulance " (flying in this case meaning rapidly moving) or in its native French, Ambulance Volante . In 1914, Antoine Depage developed the five-tiered Ordre de Triage , a triage system which set specific benchmarks on evacuation, described staged evacuation. French and Belgian doctors began using these concepts to inform

3111-503: The renowned Boissier in Paris , where he turned down an opportunity to become the supplier for the French Imperial Court. The French-inspired confectionery of Casa Capșa soon established a continent-wide reputation. The business expanded in 1881 to a full-service restaurant, at a time when quality restaurants along Western European lines were still quite a rarity in Romania. In December 1916, during World War I , following

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3172-545: The same basic process. In all systems, patients are first assessed for injuries, then, they are categorized based on the severity of those injuries. Although the number of categories differs from system to system, all have at least three in common; high severity, low severity, and deceased. Some systems involve features like scoring systems, such as the Revised Trauma Score , the Injury Severity Score , and

3233-480: The same time, Mobile Army Surgical Hospitals (MASH) were introduced along with helicopters for evacuation. These helicopters, however were used for evacuation only, and care was not provided in the air during the evacuation. These advances reduced fatalities for injured soldiers by up to 30%, and changed the nature of battlefield medicine significantly. The conditions of the Vietnam War drove further development on

3294-549: The term means to pick or to sort, it itself coming from the Old French verb trier , meaning to separate, sort, shift, or select; with trier in turn came from late Latin tritare, to grind. Although the concept existed much earlier, at least as far back as the reign of Maximillian I , it was not until the 1800s that the Old French trier was used to describe the practice of triage. That year, Baron Dominique-Jean Larrey ,

3355-565: The time, no decontamination procedures or gas masks were available for incidents involving contaminants. In response, the Japan Self-Defense Forces created a decontamination team, which was then instrumental to the response of the Tokyo subway sarin attack which occurred only seven months later. As medical technology has advanced, so have modern approaches to triage, which are increasingly based on scientific models. The categorizations of

3416-472: The treatment of casualties at aid stations behind the front. Those responsible for the removal of the wounded from a battlefield or their care afterwards would divide the victims into three categories: From that delineation, aid workers would follow the Ordre de Triage : In the first order of triage, the injured would be evacuated to clearing stations in the night, when darkness offered maximum protection from

3477-523: The turn of the [19th] century... it degenerated into a Communist party haunt for the illiterate and intellectually unendowed party bosses." Mioara Ioniță writes, "Its fame remains, but it has lost some of its pre-war glamour. It exists as such, but the spirit that animated it has vanished." The enterprise was expanded in 1886 to include the Capșa Hotel, initially a guest house for members of parliament from out of town. The French manager had formerly managed

3538-460: The victims are frequently the result of triage scores based on specific physiological assessment findings. Some models, such as the START model may be algorithm -based. As triage concepts become more sophisticated, and to improve patient safety and quality of care, several human-in-the-loop decision-support tools have been designed on top of triage systems to standardize and automate the triage process (e.g., eCTAS, NHS 111 ) in both hospitals and

3599-539: The wake of the 2016 Nice truck attack , the hotel's main hall was used to triage wounded civilians. The hotel hosted the opening ceremony of the Junior Eurovision Song Contest 2023 on November 20, 2023. 43°41′40″N 7°15′27″E  /  43.69444°N 7.25750°E  / 43.69444; 7.25750 This article about a French hotel or resort is a stub . You can help Misplaced Pages by expanding it . Casa Cap%C8%99a Casa Capșa

3660-534: Was converted to a hospital. By the end of the war, the number of wealthy visitors to the Riviera had dropped off to the point that the hotel was in severe financial difficulty. Seized by creditors, the Negresco was sold to a Belgian company. Henri Negresco died a few years later in Paris at the age of 52. February 28, 1948, Suzy Delair sang C'est si bon in this hotel during the first Nice Jazz Festival . Louis Armstrong

3721-619: Was present and loved the song. June 26, 1950, he recorded the American version of the song (English lyrics by Jerry Seelen ) in New York City with Sy Oliver and his Orchestra. When it was released, the disc was a worldwide success and the song was then performed by the greatest international singers. Over the years, the hotel had its ups and downs, and in 1957, it was sold to the Augier family. Madame Jeanne Augier  [ fr ] reinvigorated

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