Triage Practices

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We are reviewing the away we triage patients in our busy ER- both walk-ins and ambulance patients. Please tell me how your triage system operates from point of entry until MD eval. Thanks

1. Pt. takes a number, admitting clerk buzzez for our attention and an RN first screens the pt. for SARS then triages the pt.

We follow the Canadian Triage Acuity Scale level 1-5 (1 life threatening needs to be seen stat by MD, 2 - emergent needs to be seen by MD with 15 mins, 3 - urgent needs to be seen by MD within 1/2 hr. , 4 - needs to be seen within 1 hr., 5 - needs to be seen within 2 hrs.). It is really easy to follow and we have advance medical directives that are in situ to be used for example: Chest pain - protocol for ASA, 15 lead ECG, IV NSS @ TKVO, Labs.

Triage nurse is responsible for reassessing patients while waiting in our waiting room.

I have attachments if anyone is interested in seeing our flow sheet.

Have a nice day.

Sarah

Sarah,hi I would like your attachments if possible. Also, I have heard about the Canadian Systems and the Estimated Severity Index-would you know where I could get info on these systems? Thank you,Becky

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Sarah,hi I would like your attachments if possible. Also, I have heard about the Canadian Systems and the Estimated Severity Index-would you know where I could get info on these systems? Thank you,Becky

gorilla...

I have little info as well...

The ENA has the ESI 5 tier system info. Check out their website.

The Canadian system is similar but there are times attached to each tier.

I don't know about your hospital...but at mine...times being layed down like law could be the kiss of death for the health care giver and a "sweet surprise" to the litigators!

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Sarah,hi I would like your attachments if possible. Also, I have heard about the Canadian Systems and the Estimated Severity Index-would you know where I could get info on these systems? Thank you,Becky

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Just p.m. your email and I will send them to you. Can you share the Estimated Index screen? Let me know.

Thanks,

Sarah

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After filling out a form that registers the patient's chief complaint, the first person a patient sees in the triage room is an MD. Follow the link below.

http://www.cep.com/rme/rmesummary.asp

-Mark

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all of our patients enter the same door, squads and walkins alike. in fairytale land, the patient is greeted by a nurse. name, ssn, dob, and general complaint is taken and the nurse decides whether the patient goes to a room, hallway, fast track, or lobby. quick reg sheet to registration so the name can get into the computer if we need stat orders for ekgs, chest x-ray, etc.

the patient name is placed in the appropriate space on the general flow board with a circle left open so that a nurse can pick up that patient. complete registration is done at the bedside.

that being said, i don't really care for our triage system. it only gives you an eyeball look at the patient but doesn't give you anything else to go on (i.e. vitals). it will sometimes land a patient in the track for a "headache, i've had them before" symptom until you vital them and the bp is 193/105 with blurred vision and nausea.

we do the best we can with what the powers that be deem appropriate.

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Just p.m. your email and I will send them to you. Can you share the Estimated Index screen? Let me know.

Thanks,

Sarah

Sarah, my e-mail is bgiardin.chnola.org- I have not been able to find anything on the ESI yet-if I do I will be glad to send it to you. Thanks, Becky

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Specializes in Home Health Case Mgr.

My facility uses the T-system of triage and documentation...ALSO, very important here.....any ambulatory or ems patient ALWAYS speaks to a NURSE first, not a check-in clerk. Too many bad things can happen here, ie. the patient or the clerk, not recognizing impending doom... "T-system" triage and charting takes over on priority of patients. Once triaged, the pt, or relative checks them in with the non medically trained clerk. If arriving by ems, the clerk comes to bedside to check pt. in..................C

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We use the 5 level system to triage.

Ambulance entrance is separate from walk in. Folks come to the registration desk first. We are all locked in behind a big glass and concrete wall. There is always at least one security officer at the desk to field complaints.

On duty is one clerk, 1-3 security people, 1-3 RNs one tech, and one transporter. Staffing depends on time of day and how crowded it is.

We have 3 triage rooms and five triage waiting chairs inside the triage area. Patient sees the registration clerk first, puts their basic info and complaint into the computer. All areas of the ED, main, peds, and our minor injury area sees who's in the waiting room and triage.

The tech calls the patients back to us depending on how long they have been there, and does their vitals, then puts them in the triage chair to wait for a nurse. ONLY the patient is allowed back unless they need a translator or they are a minor, then only one other person comes with them. We rarely make exceptions.

As stated everywhere else, if a person really does look emergent they go straight back to the main where the nurse there will triage them.

The nurse in one of the rooms will call a patient in, triage them and assign their condition level and either send them back to the main waiting room, or call the charge nurse for a bed assignment. We used to be able to assign the beds ourselves, but that got a little crazy.

If Peds isn't busy, they will call us an say they'll take patients. Nurses in the ED parts can also take patients by putting their bed number next to the pt name on the computer.

Transporter gets the data sheet print outs and takes the patients back to their beds and instructs them to change into a gown.

If a patient walks in with chest pain, we do the EKG in triage. If any patient looks like they will need a line and bloodwork, we do that in triage also when all other beds are full, and will keep monitoring them in triage until a bed is available.

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Sarah, my e-mail is bgiardin.chnola.org- I have not been able to find anything on the ESI yet-if I do I will be glad to send it to you. Thanks, Becky

Hi Becky,

Your email is not valid...it states "not a valid internet email". I attempted 3 times and made sure I copied it down but it didn't send. Is that an email address? Let me know and I'll try again.

Sarah

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My facility uses the T-system of triage and documentation...ALSO, very important here.....any ambulatory or ems patient ALWAYS speaks to a NURSE first, not a check-in clerk. Too many bad things can happen here, ie. the patient or the clerk, not recognizing impending doom... "T-system" triage and charting takes over on priority of patients. Once triaged, the pt, or relative checks them in with the non medically trained clerk. If arriving by ems, the clerk comes to bedside to check pt. in..................C

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Where would I find information on the T-system? Please advise.

Thanks,

Sarah

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Hi Becky,

Your email is not valid...it states "not a valid internet email". I attempted 3 times and made sure I copied it down but it didn't send. Is that an email address? Let me know and I'll try again.

Sarah

Sarah, I am so sorry-should be [email protected]-thanks for getting back with me. Becky

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For information on Canadian Triage Standards go to the website for the Canadian Emergency Physicians, click on Policies and Gudelines on the left menu, then CTAS on the top menu.

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