triage sheets

  1. I am curious as to what types of setup different ER's have for there triage sheets. We are currently in the process of redesigning ours. We are a community hospital with a 40 bed ER. Any help would be greatly apppreciated. Thanks!
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    About ernurse728

    Joined: Jun '02; Posts: 132; Likes: 3
    emergency room nurse


  3. by   CMERN
    Top part of sheet-Demographic Info and C/C.
    Middle part of sheet- current VS and med info.(allergies and current meds) and Cultural/religous/learning or special needs.
    Bottom Part of sheet-assement from Head to to toe with check offs for each assessing tool prompt, 0-10 pain scale on side of sheet in eng/and spanish
    Very Bottom of sheet open lines to write any Misc Info/interventions done in triage/or changes in V/S.... Hope this helps..I like OUr sheet.
    Last edit by CMERN on Dec 5, '02
  4. by   l.rae
    the front left half is the triage/hx/vs...right side is initial assess, objective data, on the back is the nursing documentatin for the visit with mar/iv flow/vs etc....we have about a dozen different focus sheets, MVA, respiratory, chest pain....there are check-offs r/t primary complaint, like, monitor/o2/ekg would be on the chest pain sheet. It's called a t-sheet system..we just changed....l don't care very much for it.....yet...........LR
  5. by   neneRN
    We use a one page sheet; Top to bottom:

    name, DOB, age, sex, VS,Triage code (for acuity)
    allergies, Tx prior to arrival (EMS)
    medical history (check off for majors-cardiac, COPD, IDDM,etc-and an additional line for not so common)
    Surgical history (again check off and addditional line)
    Check off boxes for chief complaint
    lines for head to toe with checkoff for breath sounds, distress level, skin (WNL, pale, diaphoretic, etc), and 1-10 pain scale
    nurse signature
    MD signature (after exam)

    It flows really well, and is easy to use and to call report from.
  6. by   2ndCareerRN
    Triage sheet!? Oh yes, I remember the nice simple to use, flow sheets that actually told people why the pt was being seen.

    Now days I have a wonderful, (well, that is what they tell us), computer program that goes through 5 screens to get the same information. Going paperless was one of the best moves we made ( according to the office supply store). Our paper use has gone up by about 8 times....go figure. It has also just about tripled the time it takes to triage a least it means job security for the IS types.

  7. by   kaycee
    Our triage assessment is 3 pages, so you don't want to know.
  8. by   Scooby365
    triage sheet......triage sheet........we just reworked ours too.......after all the tears and the bloodshed we ended up with a monstrosity that was neither functional nor asthetically pleasing.....good luck
  9. by   RNFROG3
    Happy to send you a hard copy of ours if you like. A new grad and I worked on it 2 years ago and got it approved. It's not perfect but it isn't too horrible. It takes about 5-7 minutes to complete if the pt answers the questions and doesn't ramble too much
  10. by   CMERN
    LORd have mercy ---2ndcarreer rn----I do hope that we do not go paperless...I prefer my 1 page triage sheet vs. any freakin computer... But bet we head that way soon ..we saw the most E.R. pts in our state so far this year.
  11. by   Sarah, RNBScN
    Are any of you interested in snail mailing a copy of your triage forms and we can exchange. Please pm and we can exchange mailing addresses or fax it if it isn't too long.

    Any ideas?