This is a lecture by Antoinette Bradshaw from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
I picked that presentation from the internet and edited it, all rights reserved to the original owner. Anyhow this presentation might be helpful for med students doing their emergency rotation/elective and especially those who don't have an instructor or any kind of mentor in their emergency elective, like me.
Definition of Triagea
Triage is the term derived from the French verb trier meaning to sort or to choose
It’s the process by which patients classified according to the type and urgency of their conditions to get the . Right patient to the
Right place at the
Right time with the
Right care provider
These indicators included: Falls, Falls with Injury, Nursing Care Hours per Patient Day, Skill Mix, Pressure Ulcer Prevalence, and Hospital-Acquired Pressure Ulcer Prevalence.
Triage is the term derived from the French verb trier meaning to sort or to choose
It’s the process by which patients classified according to the type and urgency of their conditions to get the Right patient to the Right place at the
Right time with the
Right care provider
Hello ,
Disaster management is a vast topic which cant be cover in one ppt so i have taken one particular topic which is on Triage in disaster Management . I am trying to elaborate the topics by putting few pictures , if anyone have any problem with understand the ppt ,I have mentioned the reference guide . They can check it .
Thnks
KIRTTI
I picked that presentation from the internet and edited it, all rights reserved to the original owner. Anyhow this presentation might be helpful for med students doing their emergency rotation/elective and especially those who don't have an instructor or any kind of mentor in their emergency elective, like me.
Definition of Triagea
Triage is the term derived from the French verb trier meaning to sort or to choose
It’s the process by which patients classified according to the type and urgency of their conditions to get the . Right patient to the
Right place at the
Right time with the
Right care provider
These indicators included: Falls, Falls with Injury, Nursing Care Hours per Patient Day, Skill Mix, Pressure Ulcer Prevalence, and Hospital-Acquired Pressure Ulcer Prevalence.
Triage is the term derived from the French verb trier meaning to sort or to choose
It’s the process by which patients classified according to the type and urgency of their conditions to get the Right patient to the Right place at the
Right time with the
Right care provider
Hello ,
Disaster management is a vast topic which cant be cover in one ppt so i have taken one particular topic which is on Triage in disaster Management . I am trying to elaborate the topics by putting few pictures , if anyone have any problem with understand the ppt ,I have mentioned the reference guide . They can check it .
Thnks
KIRTTI
There are several main dimensions most frequently used to measure hospitals performance via clinical efficiency ( Clinical quality , evidence -based practices , health improvement and outcomes for individual and patients)
The Pressure Ulcer Scale for Healing (PUSH) tool is a fast and accurate tool used to measure the status of pressure wounds over time. The tool was designed by the National Pressure Ulcer Advisory Panel (NPUAP) and has been validated many times over.
oint Commission International Accreditation Standards for Hospitals, 6th Edition, provides the basis for accreditation of hospitals throughout the world. Joint Commission International (JCI) standards define the performance expectations, structures, and functions that must be in place for a hospital to be accredited by JCI. The standards are divided into two main sections: 1) patient-centered care and 2) health care organization management.
This presentation on Triage and transport deals with how we should we deal with the patients who are attending the emergency department and to provide best treatment for the needy patients at appropriate time.
I hope this will be helpful to nurses, paramedics, graduate and under graduate students and emergency doctors and team.
Educational powerpoint on Emergency patient presentations.
It describes the allocation of a patient triage score based on the clinical condition on arrival in the Emergency Department
There are several main dimensions most frequently used to measure hospitals performance via clinical efficiency ( Clinical quality , evidence -based practices , health improvement and outcomes for individual and patients)
The Pressure Ulcer Scale for Healing (PUSH) tool is a fast and accurate tool used to measure the status of pressure wounds over time. The tool was designed by the National Pressure Ulcer Advisory Panel (NPUAP) and has been validated many times over.
oint Commission International Accreditation Standards for Hospitals, 6th Edition, provides the basis for accreditation of hospitals throughout the world. Joint Commission International (JCI) standards define the performance expectations, structures, and functions that must be in place for a hospital to be accredited by JCI. The standards are divided into two main sections: 1) patient-centered care and 2) health care organization management.
This presentation on Triage and transport deals with how we should we deal with the patients who are attending the emergency department and to provide best treatment for the needy patients at appropriate time.
I hope this will be helpful to nurses, paramedics, graduate and under graduate students and emergency doctors and team.
Educational powerpoint on Emergency patient presentations.
It describes the allocation of a patient triage score based on the clinical condition on arrival in the Emergency Department
Triage is a French word meaning “to sort.” Developing a claims triage strategy allows a company to obtain a good overview of the claims situation and allocate resources appropriately. Attend this session to learn more about sorting your claims to make the best use of available resources.
the emergency assessment to be done carefully and immediately .the emergency nurse have quick review and deliver the health carein the quality manner in all the fields of health care as medical,surgical, paediatric ,and obstertics .
UNIT-9 NURSING MANAGEMENT OF PATIENT IN CRITICAL CARE.pptxNirmal Vaghela
Nursing management of patients in critical care involves monitoring vital signs, administering medications, managing ventilator support, providing wound care, ensuring infection control, and offering emotional support to both patients and their families. Nurses play a crucial role in coordinating care and advocating for the best possible outcomes for patients in critical condition.
performing a successful triage at the hospital level. triaging for infants, children, and adults.
nevertheless, the triage area must be well secured. the area must be signed. babies less than one-month-old must be seen immediately by a physician without delay in a queue. triaging must be carried out by an adequately trained caregiver.
GEMC - Nursing Assessment and ResuscitationOpen.Michigan
This is a lecture by Antoinette Bradshaw from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Objectives:
By the end of this call, you will be able to:
•Describe the processes of Root-Cause Analysis (RCA) and Multi-Incident Analysis (MIA) and their role in quality improvement
•Compare and contrast the different approaches to collecting hospital-acquired VTE data
•Identify an approach suitable for improving patient safety at your institution
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Jim Holliman, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Alterations in Body Temperature: The Adult Patient with a Fever- Reside...Open.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Rapid Sequence Intubation & Emergency Airway Support in the Pediatric E...Open.Michigan
This is a lecture by Michele Nypaver, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Disorders of the Pleura, Mediastinum, and Chest Wall- Resident TrainingOpen.Michigan
This is a lecture by Andrew Barnosky, DO from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Dental Emergencies and Common Dental Blocks- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Arthritis and Arthrocentesis- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Bursitis, Tendonitis, Fibromyalgia, and RSD- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Right Upper Quadrant Ultrasound- Resident TrainingOpen.Michigan
This is a lecture by Jeff Holmes from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC: Nursing Process and Linkage between Theory and PracticeOpen.Michigan
This is a lecture by Jeremy Lapham from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
2014 gemc-nursing-lapham-general survey and patient care managementOpen.Michigan
This is a lecture by Dr. Jeremy Lapham from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Dr. Jessica Holly from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC: The Role of Radiography in the Initial Evaluation of C-Spine TraumaOpen.Michigan
This is a lecture by Dr. Stephen Hartsell from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Dr. Jim Holliman from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
MATATAG CURRICULUM: ASSESSING THE READINESS OF ELEM. PUBLIC SCHOOL TEACHERS I...NelTorrente
In this research, it concludes that while the readiness of teachers in Caloocan City to implement the MATATAG Curriculum is generally positive, targeted efforts in professional development, resource distribution, support networks, and comprehensive preparation can address the existing gaps and ensure successful curriculum implementation.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Delivering Micro-Credentials in Technical and Vocational Education and TrainingAG2 Design
Explore how micro-credentials are transforming Technical and Vocational Education and Training (TVET) with this comprehensive slide deck. Discover what micro-credentials are, their importance in TVET, the advantages they offer, and the insights from industry experts. Additionally, learn about the top software applications available for creating and managing micro-credentials. This presentation also includes valuable resources and a discussion on the future of these specialised certifications.
For more detailed information on delivering micro-credentials in TVET, visit this https://tvettrainer.com/delivering-micro-credentials-in-tvet/
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
South African Journal of Science: Writing with integrity workshop (2024)
GEMC - Trauma - Triage - for Nurses
1. Author(s): Antoinette A. Bradshaw, PhD, MS, BSN, RN, 2011
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6. COURSE OBJECTIVES
*TO DEFINE THE MAJOR OBJECTIVES OF TRIAGE AND THE
ROLE OF TRIAGE WITHIN THE EMERGENCY MEDICAL SYSTEM
*TO DEFINE THE MAJOR TYPES OF TRIAGE PRACTICES
*TO DESCRIBE AND APPLY THE CAPE TRIAGE SCORING
SYSTEM
*TO APPLY THE NURSING PROCESS WHEN ANALYZING THE
TRIAGE CASE SCENARIO
*TO DELINEATE THE NURSING PROCESS DURING TRIAGE
*TO PREDICT CAPE TRIAGE SCORE WHEN PRESENTED WITH
SPECIFIC INFORMATION REGARDING THE PATIENT S
HISTORY AND CONSIDER AGE SPECIFIC FACTORS
* TO EMPOWER THE NURSES WITH KNOWLEDGE TO BECOME
SKILLED AT TRIAGE
7. WHAT IS TRIAGE?
Triage is the process of determining
the priority of patients' treatments
based on the severity of their condition.
This rations patient treatment
efficiently when resources are
insufficient for all to be treated
immediately. The term comes from the
French verb trier, meaning to separate,
sort, sift or select.
8. The Purpose & Benefits of
Triage
~ To expedite the delivery of time-critical treatment
for patients with life-threatening conditions
~To ensure that ALL people requiring emergency
care are appropriately categorized according to
their clinical condition
~ To improve patient flow
~ To improve patient satisfaction
~ To decrease the patient s overall length of stay
~ To facilitate streaming of less urgent patients
~ To be user-friendly for all levels of health care
professionals
9. ROLE OF TRIAGE NURSE
To competently assess all
incoming patients to properly
place them in categories
according to the Triage Early
Warning Score (TEWS)
10. NURSING QUALIFICATIONS
FOR TRIAGE
1. Ideally the nurse should have worked in
the Emergency Department for a minimum
of 6 months
2. A nurse must go through the Emergency
Department orientation program
3. The nurse must complete at least four
month rotation through the various hospital
units including the ED
11. The Significance of Nurses in
The Triage Process
Compared to other countries whose doctor
to nurse ratios range from 1:4 to 1:1.6, in
South Africa the Ratio of doctors to nurses is
1:8. Thus, the nurses have a critical role in
assisting the physicians in assessing patients
for initial treatment as well as in the
ongoing delivery of care.
15. CANADIAN TRIAGE AND ACUITY SCALE (CTAS)
NATIONAL GUIDELINES
CTAS Level 1 - Patients need to be seen by a
physician immediately 98% of the time.
CTAS Level 2 - Patients need to be seen by a
physician within 15 minutes 95% of the time.
CTAS Level 3 - Patients need to be seen by a
physician within 30 minutes 90% of the time.
CTAS Level 4 - Patients need to be seen by a
physician within 60 minutes 85% of the time.
CTAS Level 5 - Patients need to be seen by a
physician within 120 minutes 80 % of the time.
16. EMERGENCY SEVERITY INDEX
The Emergency Severity Index is a 5 level
tool for use in emergency department
triage. Experienced ER nurses use the ESI
to rate patient s acuity on a scale of 1-5.
17. Level 1: Immediate life saving intervention required
Level 2: High risk situation (Confused, lethargic,
disoriented, severe pain or distress)
Level 3: Multiple Resources are required. (Consider
upgrading to level 2 if vital signs are in the danger
zone (<3 months HR >180, >RR 50 and O2 sats
<92%, 3 months to 3 years HR >160, RR >40 and
O2 sats <92%, 3 years to 8 years HR >140, >RR 30
and O2 sats < 92% and over 8 years, HR >100, RR
>20 and O2 sats < 92%)
Level 4: One resource required
Level 5: No resources needed
18. SOUTH AFRICA TRIAGE SCORE
In 2004 the South African Triage Group
(SATG) formerly known as the Cape
Triage Group) was convened under the
auspices of the Joint Division of
Emergency Medicine and the University of
Cape Town and Stellenbosch. The aim of
the STAG was to produce a triage score
for use throughout South Africa.
19. KEY TRIAGE CONCEPTS
~RED VS RESUSCITATION
~ACUTE VS CHRONIC
~CHILDREN AND INFANTS
~TEWS CALCULATOR
20. 3 VERSIONS OF STATS
~INFANT (50 CM TO 95 CM ~ ONE WEEK
TO ALMOST 3 YEARS OF AGE)
~CHILDREN (96 CM – 150 CM 3 YEARS TO
12 YEARS OF AGE)
~ADULT (OVER 150 CM)
21. TEWS CALCULATOR
~ THIS CONSISTS OF 2 PARTS:
VITAL SIGNS AND MOBILITY
If the vital signs are WNL and the patient is alert and
ambulatory with no trauma, the score will be 0.
The score will increase or decrease depending on these
factors and whether they are too high, too low, if trauma
has occurred or if they need assistance with mobility.
***Please note that each vital sign must be monitored to
achieve an accurate score
22. Physiological Symptoms affected by
Vital Signs
~B/P and heart rate monitor the cardiovascular
~Respiratory rate monitors the respiratory system
~Temperature monitors the thermoregulatory
system
~AVPU monitors the central the central nervous
system
~Mobility monitors the musculoskeletal system
~Trauma refers to the presence of any injury
23. The second discriminator is the
part that generates the actual
triage color (red, orange,
yellow, green or blue)
which will determine the
severity level and essentially
when the patient will be
attended to.
24. These discriminators are again
broken into 3 categories:
~INFANT (50 CM TO 95 CM ~ ONE WEEK
TO ALMOST 3 YEARS OF AGE)
~CHILDREN (96 CM – 150 CM 3 YEARS TO
12 YEARS OF AGE)
~ADULT (OVER 150 CM)
25. Stepwise approach for triage
~ Step 1: Take a brief history directed at the main
complaint and document this
~ Step 2:Measure vital signs and document the
findings
~ Step 3: Calculate the TEWS and document the
total value
~ Step 4: Match the scores to the discriminator list
and observe the discriminator list for possible
discriminators not picked up by the TEWS
~ Step 5: Document the triage code and act
accordingly
26. A decision regarding the acuity
of the patient s condition
should not me made until the
whole stepwise approach has
been completed.
27. The history is the main presenting
complaint. This information can be
obtained by questioning the patient,
the escort (if the patient is unable to
give a history) or by reading the
referral letter.
***Always ask the question: What is
your emergency? or What brings
you to the hospital today?
30. MOBILITY IS OBSERVED BY
NOTING THE MODE IN WHICH
THE PATIENT HAS TO BE
MOBILIZED AND TRAUMA
SCORING ASSESSES WHETHER
THE PATIENT HAS HAD ANY
INJURIES.
33. ~CHILD TEWS CALCULATOR ~
SCORING EXAMPLE
A child walks into the emergency department
with a RR of 32 and a heart rate of 140, a
temperature of 38.3 and the patient is awake and
alert but color is pale and abdomen is firm and
distended.
When questioned, the parents state he has been
vomiting with for 2 days with right lower
quadrant pain. There are no signs of trauma.
When abdomen is touched, patient screams in
pain. (Calculate color code)
34. Triage Early Warning Score (TEWS) - Children
CHILD TRIAGE SCORE
(3 to 12 years old / 96 to 150 cm tall)
3
2
0
1
2
Walking
Mobility
1
With Help
Stretcher/
Immobile
RR
less than
15
15-16
17-21
22-26
27 or more
HR
less than
60
60-79
80-99
100-129
130 or
more
Temp
Feels cold
OR
Under 35
35-38.4
AVPU
Confused
Alert
Reacts to
Voice
No
Yes
3
Trauma
Feels hot
OR
Over 38.4
Reacts to
Pain
Unresponsive
35. CHILD TEWS Scoring
~Mobility ~ Walked ~ 0
~Respiratory rate ~ 32 ~ 2
~Heart rate ~ 140 ~2
~B/P ~ n/a
~Temperature ~ 38.3 ~ 0
~AVPU ~ awake and alert ~ 0
~Trauma ~ no signs of injury or bruising ~ 0
Total score ~ 5 (What color code would this
be?) Discussion…..What other factors would
you consider in your scoring decision?
36. Colour
TEWS
RED
7 or more
ORANGE
5-6
YELLOW
3-4
GREEN
0-2
Target time to treat
Immediate
less than 10 mins
less than 60 mins
less than 240 mins
Mechanism of injury
BLUE
DEAD
High energy transfer
Shortness of breath - acute
Coughing blood
Chest pain
Haemorrhage - uncontrolled
Seizure - current
Haemorrhage - controlled
Seizure - post ictal
Focal neurology - acute
Level of consciousness
reduced
Psychosis / Aggression
DEAD
Threatened limb
Dislocation joint
Presentation
other
Fracture - compound
Dislocation finger or toe
Fracture -
closed
ALL
OTHER
PATIENTS
Burn over 20%
Burn –
face / inhalation
Burn - electrical
Burn - circumferential
Burns - other
Burn - chemical
Poisoning / Overdose
Hypoglycaemia –
glucose less than 3
Diabetic over 11
Vomiting -
glucose
& ketonuria
fresh blood
Pregnancy & abdominal
trauma or pain
Pain
Severe
Abdominal pain
Diabetic glucose over 17
(no ketonuria)
Vomiting - persistent
Pregnancy & trauma
Pregnancy &
bleed
Moderate
PV
Senior Healthcare Professional’s Discretion
Mild
37. ~ ADULT TEWS CALCULATOR ~
SCORING EXAMPLE
An adult patient arrives in a wheelchair with
a RR of 28 and a pulse of 129. The B/P is
200/98, temperature is 37.0 and the patient
is alert and oriented.
When questioned, the patient noted that
there had been no trauma and no physical
wounds, lacerations or bruising were noted.
38. Triage Early Warning Score (TEWS) - Adult
ADULT TRIAGE SCORE
(over 12 years / taller than 150cm)
3
2
1
1
2
Walking
With Help
Stretcher/
Immobile
9-14
Mobility
0
3
15-20
21-29
more than 29
RR
101-110
111-129
more than 129
HR
Mobility
RR
less than 9
HR
less than
41
41-50
51-100
71–80
81-100
101-199
more than
199
SBP
Feels hot
OR
over 38.4
Temp
SBP
less than
71
Temp
Feels cold
OR
Under 35
35-38.4
AVPU
Confused
Alert
Reacts to
Voice
No
Yes
Trauma
Reacts to
Pain
Unresponsive
AVPU
Trauma
39. TEWS Scoring
~Mobility ~ Wheelchair ~ 1
~Respiratory rate ~ 28 ~ 2
~Heart rate ~ 129 ~2
~B/P ~ 200/98 ~ 2
~Temperature ~ 37.0 ~ 0
~AVPU ~ awake and alert ~ 0
~Trauma ~ no signs of injury or bruising ~ 0
Total score ~ 7 (What color code would this
be?)
40. DISCRIMINATORS
After the triage code according to the TEWS
discriminators are addressed by placing the
right hand over the selected color code.
Based on the history taken the triage code
may be changed to the corresponding
column in which the discriminator was
found.
41. Utilize the TEWS Scores and
also use your assessment skills,
knowledge & expertise to
determine whether to upgrade a
patient or ask for colleague/
physician input regarding your
triage placement decision.
42. TRIAGING UP IS ESSENTIAL TO
THE PROCESS AND MUST BE DONE
WHERE DISCRIMINATORS OUTTRIAGE THE TEWS.
TRIAGE DOWN IS NOT A PART OF
THE TRIAGE PROVIDERS DUTY
BUT CAN BE DONE BY THE SENIOR
HEALTHCARE PROVIDER.
43. Initial Triage-Based Treatment
and Diagnostic Tests
First Aid (splints, ice packs, pressure
dressings)
Analgesia and antipyretic control
Simple diagnostic Aids (glucometers, pulse
ox)
47. Illness/Injury Specific
Considerations
~ Coughing patient with known TB
~Hemorrhaging Pregnant Woman
~Concerned Parent with Screaming
Child
Creative Donkey, "Crying Child", flickr
The Noun Project, Infectious Disease
48. Triage Early Warning Score (TEWS) - Children
CHILD TRIAGE SCORE
(3 to 12 years old / 96 to 150 cm tall)
)
3
2
0
1
2
Walking
Mobility
1
3
With Help
Stretcher/
Immobile
Mobility
RR
less than
15
15-16
17-21
22-26
27 or more
RR
HR
less than
60
60-79
80-99
100-129
130 or more
HR
Temp
Feels cold
OR
Under 35
35-38.4
Feels hot
OR
Over 38.4
Temp
AVPU
Confused
Alert
Reacts to
Voice
No
Yes
Trauma
Reacts to
Pain
Unresponsive
AVPU
Trauma
49. Triage Early Warning Score (TEWS) - Infants
INFANT TRIAGE SCORE
(younger than 3 years / smaller than 95cm)
3
2
1
0
1
2
Normal for
age
Mobility
3
Stretcher/
Immobile
Mobility
RR
less than 20
20-25
26-39
40-49
50 or more
RR
HR
less than 70
70-79
80-130
131-159
160 or more
HR
Feels cold
OR
Under 35
35-38.4
Feels hot
OR
Over 38.4
Temp
AVPU
Alert
Reacts to
Voice
Trauma
No
Yes
Reacts to
Pain
Temp
Unresponsive
AVPU
Trauma
50. The Color Designation Discriminators are also divided into 3 categories
They also include: Infant, Child and Adult
Colour
TEWS
RED
7 or more
ORANGE
5-6
YELLOW
3-4
GREEN
0-2
Target time to treat
Immediate
less than 10 mins
less than 60 mins
less than 240 mins
Mechanism of
injury
BLUE
DEAD
High energy transfer
Shortness of breath - acute
Coughing blood
Chest pain
Haemorrhage - uncontrolled
Seizure - current
Haemorrhage - controlled
Seizure - post ictal
Focal neurology - acute
Level of consciousness
reduced
Psychosis / Aggression
Threatened limb
Dislocation other
joint
Presentation
Fracture - compound
DEAD
Dislocation finger or toe
Fracture -
closed
Burn over 20%
Burn –
face / inhalation
Burn - electrical
Burn - circumferential
Burns - other
Burn - chemical
Poisoning / Overdose
Hypoglycaemia –
glucose less than 3
Diabetic over 11
Vomiting -
glucose
& ketonuria
fresh blood
Pregnancy & abdominal
trauma or pain
Abdominal pain
Diabetic glucose over 17
(no ketonuria)
Vomiting - persistent
Pregnancy & trauma
Pregnancy &
bleed
PV
ALL
OTHER
PATIENTS
51. IT IS ONLY THROUGH PRACTICE
AND REPETITION THAT A NURSE
WILL BECOME SKILLED WITH
TRIAGE. THEREFORE, IT IS
ENCOURAGED THAT YOU
PARICIPATE IN THE TRIAGE
PROCESS AS FREQUENTLY AS
POSSIBLE IN ORDER TO STAY IN
PRACTICE AND UP TO DATE
52. Summary
Triage is an essentially 1st step
in the efficient and effective
running of any Emergency
Center. Utilized together with
common sense, education and
assessment skills, the SATS is an
excellent tool to that can save
lives and reduce morbidity.
53. Additional Source Information
for more information see: http://open.umich.edu/wiki/CitationPolicy
Slide 47, Image 1: Jack Biesek, Gladys Brenner, Margaret Faye, Healther Merrifield, Kate Keating, Wendy Olmstead, Todd Pierce, Jamie Cowgill,
Jim Bolek, "Infectious Disease" The Noun Project, http://thenounproject.com/noun/infectious-disease/#icon-No613, Public Domain.
Slide 47, Image 2: Creative Donkey, "Crying Child", flickr, http://www.flickr.com/photos/binusarina/3889528397/, CC: BY 2.0, http://
creativecommons.org/licenses/by/2.0/