Self-Triage in the Emergency Department

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[color=dimgray]"staff in one [emergency deparment] unit in new york try to overcome [subjective nature of triage] by encouraging self triage. on arrival, patients are offered forms, which they can complete with their names, personal details, and brief descriptions of why they have attended. they can then time stamp them and post them to the triage room. these forms are available in various languages and, although they contain only tick boxes to indicate categories of injuries or illnesses, they also allow patients to suggest categories of their own, in their own words. by reading them, triage nurses can review quickly who they have in the waiting room."

boag, brian (2007). nursing in new york. emergency nurse, vol 15, issue 3 p14-17.

does anyone know which hospital in new york is meant in this article?

do you use self-triage in your hospital? let me know and send a copy of you self-triage questions to me.

thanks,

friso raemaekers (er-nurse, hagahospital, the hague, the netherlands)

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Specializes in Peds, ER/Trauma.

I have never worked at a hospital that does self-triage, but I can't imagine that it would work very well. A patient's idea of "severe respiratory distress" is VERY different from an ER nurse's. A lot of people who come to the ER seem to think that their problem is life threatening when it is nowhere near life threatening- and those who truly do have life threatening conditions should not be left in the waiting room to fill out a self-triage form....

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if i continue reading in the same article:

[color=dimgray]...patients whose conditions are urgent, those who have chest pain for example, can ring the triage nurses to make [immediately contact]...

the traige questions has to be simple human behavior-language, no nursing-language (jargon).

"difficulty breathing" instead of "severe respiratory distress".

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Specializes in Peds, ER/Trauma.
if i continue reading in the same article:

[color=dimgray]...patients whose conditions are urgent, those who have chest pain for example, can ring the triage nurses to make [immediately contact]...

the traige questions has to be simple human behavior-language, no nursing-language (jargon).

"difficulty breathing" instead of "severe respiratory distress".

right, but most people's ides of severe "difficulty breathing" is much different than an er nurse's. i can't tell you how many times i've had patients tell the registration desk that they "can't breathe", then go to get them back to a room or to triage right away, and find them able to speak in long, rambling sentences with a o2 sat of 100%.....

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Specializes in ER, ICU, L&D, OR.
Right, but most people's ides of severe "difficulty breathing" is much different than an ER nurse's. I can't tell you how many times I've had patients tell the registration desk that they "can't breathe", then go to get them back to a room or to triage right away, and find them able to speak in long, rambling sentences with a O2 sat of 100%.....

There is no accounting for patient stupidity and anxiety, its completely boundless.

a 1/4 inch lac is written as a "Huge Gash"

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Specializes in Trauma Administration/Level I Trauma.

I don't see this working well..

I mean EVERYONE is a 10/10 on the pain scale and they all thing it's a life or limb emergency despite having a head cold. :uhoh21:

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Specializes in ER, ICU, L&D, OR.
I don't see this working well..

I mean EVERYONE is a 10/10 on the pain scale and they all thing it's a life or limb emergency despite having a head cold. :uhoh21:

I never ask any more

I just use the face scale

Keep It Sweet Simple

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Specializes in TraumaER ,NICUx2days, HEMEONC CathLab IV.
I never ask any more

I just use the face scale

Keep It Sweet Simple

CHART WHAT YOU SEE! "no redness no swelling no hematoma" 1cm laceration not actively bleeding (get out the 2x2 with that little measure device on the side of the packaging)

"no facial grimace, eating chips, talking on phone @ triage, laughing / family" that sums it up. add to that

ambulates w/o limp, gait steady fast., moves up from chair w/o

difficulty" VS "rocking back and forth in chair , clammy, diaphoretic, eyes sunken, retching, vomiting, holding flank, facial grimace. and listen to the chest pain patient that says they feel DOOM. holy cow there is a crash about to happen.

I hate the ones that slide out of the wheelchair for effect.

as the family overreacts feeding into the circus.:banghead:

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Specializes in med/surg---long term---pvt duty.
CHART WHAT YOU SEE! "no redness no swelling no hematom" 1cm laceration not actively bleeding (get out the 2x2 with that little measure device on the side of the packaging)

"no facial grimace, eating chips, talking on phone @ triage, laughing / family" that sums it up. add to that

ambulates w/o limp, gait steady fast., moves up from chair w/o

difficulty" VS "rocking back and forth in chair , clammy, diaphoretic, eyes sunken, retching, vomiting, holding flank, facial grimace. and listen to the chest pain patient that says they feel DOOM. holy cow there is a crash about to happen.

I hate the ones that slide out of the wheelchair for effect.

as the family overreacts feeding into the circus.:banghead:

Great example 10MG-IV :yeah: I'm a new nurse to the ER even tho I've been med/surg--long term care for over 20 years. It KILLS me how patients state they are 10/10...I need my Dilaudid Q 2 hours around the clock...eating like a horse, laughing, joking, walking all over the unit, while yapping on the cell, dying of excruciating abdominal pain...got to have it NOW. I also write what the patient "shows" not just what they say...just wish the docs would read the notes and act according, instead of ordering MORE pain meds every time the patient whines.

I have no problem medicating the patient who truly needs pain meds but now days at least where I work (many druggies), they seem few and far in between

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Specializes in Emergency Dept, ICU.

I don't think triage is the appropriate word here for this article. It seems like it's just a registration type of documentation. No vitals are taken and there is no decision making process here.

All of my patient's fill out a form before triage. If they are dying the receptionist will get me otherwise wait your turn.

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Specializes in TraumaER ,NICUx2days, HEMEONC CathLab IV.

yes, we have a form somewhat like this here in TN.

I get "foot" 'pee' "stomak hurt" "pain for 1 year" and

"headake" once no lie "headache below the waist"

Do we have a funny patient complaint thread????:nurse:

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Specializes in TraumaER ,NICUx2days, HEMEONC CathLab IV.

Now with 'self triage' everyone writes Chest Pain, or

Short of Breath. This brings them directly to the back, bypass triage, gets a stat EKG, INT ASA, O2, yada yada yada..... ( we have started to do TEMI scores on them and if all in WNL, per MD boot them out to the waiting room. ) Anyway,since our director decided we should become a "Chest Pain Center" even though we don't have clocks that are *synchronized. *That means all the clocks in the building have the same time on them for documentation purposes. We have successfully trained all residents in this county to say Chest Pain to get back ahead of the masses, even though they want a Laceration sewn. When are the Insurance companies going to catch on???

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