Paramedic triage

Hi there,

I work at a level 1 trauma center, average census >300/day and frequently work triage which is staffed with a minimum of 3 RNs, sometimes 5 depending on the census.

I'm shocked at the responses of nurses who agree with EMT-Ps working at triage. In my state (CA), RNs must perform the initial assessment whether the patient is received by ambulance or walk-in.

Aside from that, I appreciate how medics work and function in the field but there exist fundamental differences between the professions. Medics are taught to follow and function according to protocols. Nurses are able to think outside the protocol. Yes, some experienced medics are more knowledgeable in emergency care than some nurses and medics perform assessments under very difficult circumstances. However, nursing is able to address a wider spectrum of patient care than medics. Even the educational requirements of the professions differs and nurses are exposed to so much more.

Assigning a triage number based on ESI is more complicated than following the algorithm. From my experience and education as an ER nursing educator, it makes me nervous to even consider a paramedic working the triage zone. Considering the liability alone, I firmly believe that paramedics can assist in the emergency department however, assessments and triage should remain solely a nursing function.

Depends where you are really. I'd be fine with it because where i live, all our paramedics complete a university degree including clinical studies and another probationary year at the end. They get about the same training as the nursing students really. The only exception being volunteer/private service crews and transport officers (who only transfer patients between hospitals). In fact i'd probably prefer the paramedic to the nurse since the entire focus of the medics training is emergency 1st aide / triage

But i understand that a lot of places have paramedics with less training (emt's) that only do short courses. Then i'd rather have a nurse. I think my rule is: If you've spent less than a year studying medical, i don't want you deciding how much of a priority i am.

Then again, i'm the kind of person that won't bother going to a hospital for anything short of a life/death emergency, so i want someone good at the desk

From ivanh3's post I see where some pitfalls would come in.

Having people wait 3-4 hours does throw a wrench in the works, and reassessing, and basic hospital politics. I still think any advanced EMT could do a great job, given some time and training.

Hi there,

I work at a level 1 trauma center, average census >300/day and frequently work triage which is staffed with a minimum of 3 RNs, sometimes 5 depending on the census.

I'm shocked at the responses of nurses who agree with EMT-Ps working at triage. In my state (CA), RNs must perform the initial assessment whether the patient is received by ambulance or walk-in.

Aside from that, I appreciate how medics work and function in the field but there exist fundamental differences between the professions. Medics are taught to follow and function according to protocols. Nurses are able to think outside the protocol. Yes, some experienced medics are more knowledgeable in emergency care than some nurses and medics perform assessments under very difficult circumstances. However, nursing is able to address a wider spectrum of patient care than medics. Even the educational requirements of the professions differs and nurses are exposed to so much more.

Assigning a triage number based on ESI is more complicated than following the algorithm. From my experience and education as an ER nursing educator, it makes me nervous to even consider a paramedic working the triage zone. Considering the liability alone, I firmly believe that paramedics can assist in the emergency department however, assessments and triage should remain solely a nursing function.

Paramedics do not get the same training as RN's do. Nurses have at a minimum of 2 years for their degree. Paramedics have, what, a year??

My paramedic certification came with an associates degree. Two years of training, including hundreds of hours of in-hospital clinicals being precepted by RNs. Paramedics aren't just ambulance drivers. I know you didn't say that, but a lot of people don't understand what kind of training paramedics receive. Kind of in the same way that many patients treat nurses like glorified waitresses -- they don't see us as critical-thinking beings.