Ordering labs and images in triage

[whichone'spink, BSN, RN]

I wanted to know what a triage nurse is usually allowed to order on a patient while that patient is still in the waiting room.

[Okami_CCRN, BSN, RN]

In my facility the triage nurse does not order labs or x-rays. they may do an accucheck if the patient is a diabetic or hand them a specimen cup if a urine dip/HCG is needed. Usually the Main ER nurse will protocol the patient with labs and fluids, for more diagnostic exams they wait for the Doc.

[rwright15]

In ours, they usually will ask the MD if they feel strongly about something. They have to specify an MD when ordering, and that md is responsible for treating whatever is abnormal. I was told to be careful doing this b/c if it ever backfired, like if another MD picked up the chart when the pt goes back or if something is missed, the MD you order under would most likely not not back you when the heat comes down. If the facility has protocols, like for CP ect... the nurses can run it alone accd to protocol.

[nuangel1, BSN, RN]

we order labs xray urines based on triage protocols.if we feel strongly about something we ask.

[crb613, BSN, RN]

In my ER it is expected that order any xray we feel that is needed for falls/injury.Ekgs, neb tx...collect & order strep, flu, rsv, ua's, urine preg., urine triage. We also have protocols that we go by & act according to these as well.

[outlierrn]

It's usually institution specific, since, with the exception of what's covered by yout ACLS card, the medical staff has to sign off on any standing orders done by RNs.

Where I work I can do accuchecks, 12 lead ekg, initiate o2, ua/ucg, and plain films. Although I limit myself to extremities and shoulder/clavicles without checking in. Anything else, I would turf to the bedside nurse.

[LilgirlRN, ADN, RN]

In my ER we only order things from triage if all the beds are full. We do do accuchecks, EKG's etc, put people on O2 if they left theirs at home (bad pt, very bad pt!). Some of us do flu swabs, rapid strep. We've been known to remove stitches once the PA has approved it.

[Virgo_RN, BSN, RN]

In my ER we only order things from triage if all the beds are full.

Same here. If patients are flowing through quickly, everything is turfed to the bedside nurse. If it may be a while before the patient gets back, then the triage nurse might get some things started.

[hillaryedrn]

We have "initial" orders that can be started either at triage or by the bedside nurse prior to being seen my an MD. They are just basics tho, depending on the complaint. Also, depends on if we have someone available to even draw the labs at that time.

[Lunah, MSN, RN]

I wanted to know what a triage nurse is usually allowed to order on a patient while that patient is still in the waiting room.

We have triage protocols based on complaints, so we can order labs, x-rays, etc., from triage or the bedside before our docs or PAs see the patients. We're pretty judicious in using these, though. It also depends on the docs/providers who are working. For example, I know certain docs will always order lipase but not amylase, or other docs don't want rib series x-rays, but just a chest x-ray for rib injuries to check for a pneumothorax.

[aidan13]

In my facility we also have protocols in terms of blood test. As long as we order what's appropriate with the patient's symptoms. And if we have time, we do them ourselves in triage including EKG. Saved a patient once by doing an EKG on the spot. If we suspect a fracture to the extremeties we ask a doctor to do a quick assessment in the triage room and he gives us the order so we can send the patient right away to x-ray. All this is to save time and get things to move quicker.

[BrnEyedGirl, BSN, MSN, RN, APRN]

We have protocols,...ie Chest pain, vomitting diarrhea, extremity injuries, adult vs pediatric fever.....we can order according to our protocols. When a pt doesn't fit into a protocol we can sometimes grab a doc and get orders or they just wait. The only meds in our protocols are tylenol/ibuprofen,.if the pt needs more than that and needs them now then they need to be seen.