TRIAGE Goals of Triage Rapidly identify patients with

TRIAGE Goals of Triage Rapidly identify patients with

TRIAGE Goals of Triage Rapidly identify patients with urgent, life-threatening conditions Assess/determine severity and acuity

of the presenting problem Direct patients to appropriate treatment areas Re-evaluate patients awaiting treatment Advantages of Triage

Streamlines patient flow. Reduces risk of further injury/deterioration. Improves communication and public relations. Enhances teamwork. Identifies resource requirements. Establishes national benchmarks. Triage Acuity Determinants Chief complaint.

Brief triage history. Injury or illness(signs & symptoms). General appearance. Vital signs. Brief physical appraisal at triage. Triage Role To determine severity of illness or injury for each patient who enters the Emergency Department

(ED). Triage Patients should have a triage assessment within 10 minutes of arrival in the ED. Accurate triage is the key to the efficient operation of an emergency department.

Effective triage is based on the knowledge, skills and attitudes of the triage staff. Triage Process Assess and determine the severity or acuity of the presenting problem.

Process the patient into a triage level. Determine and direct the patient to appropriate treatment areas. Effectively and efficiently assign appropriate human health resources. Triage Assessment Chief complaint. Brief triage history Injury or illness (signs & symptoms) General appearance. Vital signs. Brief physical appraisal at triage.

5 Level Triage Level Level Level Level Level

1 2 3 4 5 Resuscitative Emergent Urgent Less urgent Non-urgent

Triage is a dynamic process. Reassessment & Reassessment . A patients condition may improve or deteriorate during the wait for treatment. Level I: Resuscitative

Conditions that are threats to LIFE or LIMB (or imminent risk of deterioration) requiring aggressive interventions. Time to MD: Immediate Time to Nurse: Immediate

Continuous reassessment Level I Usual presentations Code / arrest. Major trauma. Severe burns--airway compromise . Shock states.

Severe respiratory distress. Near death asthma (Status asthmatics). Tension pneumothorax. Altered mental state. Seizure (Status epileptics). Traumatic shock. Overdose. AAA.

AMI with complications. Congestive heart failure with low BP. Major head injury-unconscious. Level II Emergent Conditions that are a potential threat of life, limb or function, requiring rapid medical intervention or delegated acts.

Time to MD: 15 minutes. Time to Nurse: immediate. Reassessment time: 15 minutes. Level II Emergent

Usual presentation

Chest Pain Query MI Trauma Chemical Exposure Stroke Altered Consciousness Acute MI Severe Asthma-stridor Acute Psychotic Episode with Agitation Severe Pain 8 -10 Reassessment 15 mins Level III Urgent

Conditions that could potentially progress to a serious problem requiring emergency intervention. May be associated with significant discomfort or affecting ability to function at work or activities of daily living. Time to MD: <30 minutes.

Time to Nurse: 30 minutes. Reassessment time: 30 minutes Level III Urgent Usual presentations:

Renal colic, billary colic GI bleed with normal VS Previous seizurealert Dehydration.

Shunt dysfunction. Vital signs outside normal range. Pain scale 4 -7 \10 Moderate risk of harm to self or others. Inconsolable infant , infant not feeding. Behavior change. Reassessment 30 minutes Level IV: Less Urgent Conditions that related to patient age, distress, or potential for deterioration or

complications would benefit from intervention or reassurance within (1 2 hours) Time to MD < 60 minutes (1 hr) Time to Nurse < 60 minutes (1 hr)

Reassessment time: 60 minutes (1 hr) Level IV: Less Urgent Usual presentation:

Head injuryalert. Earache. Abdominal pain. UTI sign and symptoms. Simple laceration requiring sutures. VS normal Reassessment 1 hour Level 5: Non Urgent Conditions that may be acute but non-urgent as

well as conditions which may be part of a chronic problem with or without evidence of deterioration. The investigation or interventions could be delayed or even referred to other area of the hospital or health care system. Time to MD: 120 minutes.

Time to Nurse: 120 minutes. Reassessment time: 120 minutes Level 5: Non Urgent Usual presentation:

Strains. Sprains. Single episode of vomiting. Sore throat. Script refills. Chronic problems with no change.

Investigation or intervention for these illnesses or injuries could be delayed or even deferred. Reassessment 2 hours \120 minutes Pediatric Triage PCTAS There are three things that must be assessed and documented on all pediatric patients:

Respiratory rate. Heart rate. Capillary refill. Pediatric CTAS Poster Pocket Card Pediatric Vital Signs Must include:

Heart rate. Blood pressure. Respiratory rate. O2 saturation. Temperature. Capillary refill. Accurate weight!

Vitals Are Your Safety Net. Less Urgent and Non Urgent patients have NORMAL vital signs. Abnormal vital signs are at least an URGENT.

Triage is a dynamic process A patients condition may improve or deteriorate during the waiting for treatment Reassessment, Reassessment, Reassessment

Triage Practical Injury Prevention Injury prevention practical General Approach to POISONED Patient ABCsIV, O2, monitor


Decontaminate if organophosphates prior touching by health care professionals Lily kit for cyanide poisoning. Obtain all prescription and bottles in the household (call pharmacy). Pill count. PM Hx. Search clothes for clues, medication alerts, pills etc. Contact family members. Track marks, consider body packing or stuffing. Vital signs, Rhythm strip.

General approach to poisoned pt. What are the essential features of a 30-second toxicological exam? Vital signs- HR, RR, BP. Temperature- rectal (resp rate can affect oral temperature). Skin- color, temperature, and sweating. Odors- provide clues (their absence means nothing)

Bowel sounds and bladder function. Mental status. General approach to poisoned pt Tests GI Decontamination

Activated Charcoal Antidotes Practical

Recently Viewed Presentations

  • Initial Management of Stroke/TIA in Primary Care

    Initial Management of Stroke/TIA in Primary Care

    Stroke Mark Sudlow Consultant and Senior Lecturer Stroke Northumbria/NHCT/University of Newcastle
  • Metric System - Paulding County School District

    Metric System - Paulding County School District

    August 9th 2016 Warm Up What is the metric system? How do we use it? I will be able to: explain the process that scientific method uses as well as the safety protocols that are necessary to operating in a...
  • flexonics Jeremy Risner advisor John Canny joints Flexonics

    flexonics Jeremy Risner advisor John Canny joints Flexonics

    [2] Moon YM, Trease BP, Kota S (2002) Design of Large-Displacement Compliant Joints. To be published in Proceedings, ASME International Design Engineering Technical Conference, Montreal, Canada, September 29 - October 2 [3] Pelrine R, Kornbluh R, Pei Q, Joseph J...
  • Welcome to the American Heritage Girls!

    Welcome to the American Heritage Girls!

    to the flag . of the United States . of America. And to the Republic . for which it stands. AHG Salute. One Nation, Under God, Indivisible, with Liberty and Justice . for all." AHG Signs Up. The AHG Sign....
  • Level G -

    Level G -

    Level G. Unit 3. 1 distraught2 credence3 feckless 4 decry5 articulate6 derogatory 7 cavort8 dissemble9 eulogy 10 exhume11 evince 12 verdant13 verbiage14 murky 15 propinquity16 intractable17 piquant 18 utopian19 nefarious20 viscous21 unwonted22 primordial
  • Dual Enrollment -

    Dual Enrollment -

    Dual Enrollment - Postsecondary Institutions. Local boards of education may establish dual enrollment programs allowing certain high school students to enroll in postsecondary institutions in order to dually earn credits for a high school diploma and/or a postsecondary degree at...
  • Empty Bowls at the Table of Life -

    Empty Bowls at the Table of Life -

    first items were organic rice, sticky rice, brown rice and beef. Initiators talk was held in October to share issues and visions, the PROK cooperative In general and its activities in particular. Participants were 294 private persons and 357 churches...
  • GIS in Hydrology short course - University of Minnesota Duluth

    GIS in Hydrology short course - University of Minnesota Duluth

    (2) Line of sight tells you whether a given target is visible from a particular point of observation. It answers the question, 'Can I see that from here?' ArcView Spatial Analyst Calculate Viewshed Surface/calculate viewshed Viewshed Fields SPOT OFFSET RADIUS...