The primary objectives of an ED triage are to (ENA,1992, P. 1):
Identify patients requiring immediate care.
Determine the appropriate area for treatment
Facilitate patient flow through the ED and avoid unnecessary congestion.
4. Provide continued assessment and reassessment of arriving and waiting patients. 5. Provide information and referrals to patients and families. 6. Allay patient and family anxiety and enhance public relations.
Definition: an incident, either natural or human-made, that produces patients in numbers needing services beyond immediately available resources. May involve a large no. of patients or a small no. of patients if their needs place significant demands on resources.
The key to successful disaster management is to provide care to those who are in greatest need first and just as importantly, not provide care to to those who have little or no chance of survival. Correct triage is essential to accomplish this goal
Two-tiered systems: intial screening by RN who greets each patients on arrival, perform a primary survey and determine whether the patient is able to wait for further assessment by a second triage nurse.
Divide tasks among staff members, internal triage and external triage
Overview of three category triage acuity systems category acuity Recommended reassessment Examples Class 1 Emergent Immediately life or limb threatening continuous Cardiopulmonary arrest, severe respiratory distress, major burns, major trauma, massive uncontrolled bleeding Coma, status epil.. Class 2 Urgent Requires prompt care, but will not cause loss of life or limb if left untreated for several hours. Every 30 minutes Abdominal pain, non cardiac cp, multiple fractures, lacerations, renal calculi, Class 3 Non urgent And treatment but time is not a critical factor Every 1-2 hrs Rash, chronic headache, sprains, cold symptoms
Reassess the patient within 1-2hours of initial triage and continue to re assess on a regular basis, patients who may have presented without cardinal signs of severe illness may develop them during long waits.
Patients who appear intoxicated actually may have life threatening problems such as DKA, and should not be permitted to keep it off in the waiting room.