1. Emergency Department Triage System By Jamal Wahadneh Rn MPH and Ms Aida Salahat Rn Al-Makassaed Emergency department

3. Objectives Define Triage Define Triage system Identify different systems Describe emergency severity index Function of triage system

4. History of Triage Definition Origin Informal triage

5. Goals of Triage Primary Secondary

6. Category of triage In hospital triage Multi casualty disaster triage

7. Types of triage methods Three level Four level Five level

8. Function of triage Identify life-threatening conditions and determine acuity level of each patient

10. Reassessment in triage Level 1 =Continuous Level 2 = every 15 min Level 3 = every 60 min Level 4 = every 60 to 90 min Level 5 = every 2 hours

11. Five level system Origin of 5 level Identify different levels

12. Emergency Severity Index Definition Advantages disadvantages

13. Is patient dying ? Level II, III, IV, V Can patient wait ? How many resources ? YesNo Level I YesNo Level II EMERGENCYEMERGENCY SEVERITYSEVERITY INDEXINDEX Level III, IV, V ONE Level IV  TWO Level III NON Level V

14. What are resources ? ResourcesNot resources Labs HX and physical exam. ECG-X-rays C-T MRIPoint of care testing IV Fluids /hydration Saline or Hep lock IV /IM Medication PO. Medication Specialty consult Simple wound care (dressing check /recheck) crutches,splints,slings. Simple procedure Complex procedure

15. Key concepts Acuity level change Choose higher acuity when in doubt

16. Basic triage components Across the room assessment Triage history Physical assessment Triage decision

18. Key concept Discontinue assessment and transport the patient immediately to the treatment area if immediate care is needed. Do not delay treatment to finish the assessment

19. Triage process Establish priorities Scientific method Importance of time

20. Nursing process in triage Assessment time Vital signs Pain scale Nursing diagnosis

21. Key Concept Never assume the accident caused the presenting condition. The presenting condition may have caused the accident.

22. Interview methods Open ended Close ended Communication style Use of five sense attitude

23. How do I triage? Across the room General appearance Abcd Subjective and objective (AMPLE) Focused assessment Pains scale (Pqrst)

24. Triage decision Step1- visual Step 2- chief complaints Step3- focused assessment Step 4- pose hypothesis Step 5- determine acuity Step 6- reassess the acuity

25. Remember That: Effective triage gets the patient To the right place. At the right time. With the right care provider.

27. Questions