Priority patient...abd pain, vag bleeding, or broken arm

Specialties Emergency

Published

I just had an interview and was asked this question: you are working triage and have the following patients: a pt c/o abd pain, a pt c/o lady partsl bleeding, and a child with a broken arm, who do you see first? Using the ABC's I said lady partsl bleeding (circulation issue), however abdominal pain could also indicate internal bleeding and a broken arm could cause compromised circulation in that extremity. I was given no other information to use to answer the question...I would love to hear input from all you experienced ER nurses as to what answer you would have chosen and why...:) Thanks so much!!

Keep your fingers crossed for me!! ER nursing is my dream job!

All the people that have post on ur answer are right, but i would go with the abdominal pain, it just have the biggest chances of been more critical just think about how many organs does the abdomen has enclosed too many i would say. not to mention that it could be epigastric meaning it could also be the heart. But be positive you will probably get the job and if not that's not the only ED right, stay positive you will get there!

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Specializes in Emergency Dept. Trauma. Pediatrics.

In my ER the abdo pain would be a level 3 and take priority. Next the lady partsl bleed and then the arm. We would send the arm to xray though while waiting. Unless it was an open fracture or something like that.

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Specializes in pediatrics, ED.

If the bleeder is pregnant, or possible ectopic, that would be #1. The abdominal pain would be my 2nd choice. If the vagi bleed was a bleeding for several days etc I would bump down for the abd pain. The abd pain would depend on where the pain was whether n/v/d was present.

The arm as long as it's a stable fx not a compound would be a low man on the totem pole.

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People is obviously not enough information that's why she is asking here, just answer which one you would see first and stop saying not enough information this goes like this 1- Abd pain, Vag bleeding, Kid with the arm, just by what she got in the interview off course if they say that the vag bleeding is 500ml in the last hr and is an 82 yold lady we would see her first than the 34 abd pain that went to the Chinese restaurant. you got to go with % and usually there is bigger porcentages in that an ABD pain is always more acute than a vag bleeding

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Thanks for all the comments everyone! I also said abdominal pain because it seemed to be the most likely to be most acute and I must have gotten the question right or did okay with my other interview questions because I got the job!!! I can't wait to start!! If any of you ER nurses have any advice for a new nurse going starting in the ER I would love to hear it!!:):)

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Specializes in Pediatrics, ER.
People is obviously not enough information that's why she is asking here, just answer which one you would see first and stop saying not enough information this goes like this 1- Abd pain, Vag bleeding, Kid with the arm, just by what she got in the interview off course if they say that the vag bleeding is 500ml in the last hr and is an 82 yold lady we would see her first than the 34 abd pain that went to the Chinese restaurant. you got to go with % and usually there is bigger porcentages in that an ABD pain is always more acute than a vag bleeding

Wanttoknow, please show me your source that states the % of abdominal pain is higher acuity than that of a lady partsl bleed. I'm guessing you don't work in an ED because there simply is NOT enough information to effectively answer that triage question. If you can support your statement I'd like to see it, otherwise I strongly feel you are making fluff statements that you don't know enough about.

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Specializes in Emergency, Telemetry, Transplant.

First, as a new ER nurse (hopefully) you would not be in triage with no ER experience, so triage questions are quite a bit unfair. I've been the the ER for a year a half (an RN for almost 4 yrs), and still do not have all the experience necessary to priotize pt's based on small assessment nuances.

Also, even an experienced nurse cannot triage based on a CC alone. I have seen pt's check in with "choking, cannot breath" and all they have is a stuffy nose and a cold. On the other hand, "muscle strain in right arm" turn out to be a STEMI.

To triage pts. effectively you need to get the pts' VS, hear the pts' stories and actually see the pts. It is so unfair to make you prioritize based only by a list of CCs on various pts you know nothing else about.

Perhaps there is no right/wrong answers--the just want to see how you think and that you can make rational decisions and show logical though processes.

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Specializes in LTC, Medical, Telemetry.

It's pretty apparent that this is an interview question. The only wrong answer would be to answer the question without inquiring a little bit.

These questions are to draw out how you approach situations and what you would be interested in knowing about these three cases, not that you can triage with no information available.

BTW, all three can wait; I'm on break:cheers:

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As others have said, kind of a loaded question with very minimal info. Even in a disaster situation, you have more info on patients than that. With that kind of minimal info, I'd think you'd go abd pain, vag bleed, broken arm, as abd pain is the one that will usually require more interventions. However, I've seen cases of each of these that would take priority. Unless they were trying to get you to ask for more info, kind of ridiculous they asked such a vague question in an interview.

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