Triage Scores

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Specializes in ED, Critical Care, Street Outreach.

Hi everyone,

A debate is ongoing with my colleagues as to whether triage scores can be altered one they have been initially applied. We're an overcrowded inner city ED, patients wait in our waiting room for many hours, when their condition change do you/should we change their score? Or when they finally get a stretcher, if your physicians have fallen behind and it will be hours until they're seen and the patient's condition changes for the worse, do you/should we change the score? I ask because in our EDIS system the physicians see the higher CTAS scores first and often we need to bump people up the "tracking screen".

What do you all think?

Matt

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Specializes in Med Surg, ER, OR.

For us, we use ESI 1-5. If the patient presents and are definitely classified as a 2, but then improve, we do not decrease the acuity level. They presented as a 2 and need to be seen accordingly. However, if the patient presents as a 4 or 5 and they deteriorate, then they can be increased in acuity.

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Specializes in ED, Critical Care, Street Outreach.

Thanks. That's what I think we need to start doing, moving the 4-5 up as required.

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Specializes in ER.

I agree, as you do your reassessments you retriage at the same time. Document your new assessment findings with your new triage score. I would argue that they should be moved up OR down, depending on your new information, but I bet hospitals are worried about liabilty issues when people are triaged down. I've had regular triage assessments where someone was groaning in pain, but comfortable and chatting once they got out to the waiting room. Or kids that are frightened of the nurse and act a little subdued, but runa nd giggle once they're out with their families. So long as your assessment is documented I think it should be fine.

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Specializes in Trauma/ED.

There are times when I call the triage nurse to make sure the patient they just made a 2 really is a 2 (ie. 21 y.o. female with CP)...and if the patient they made a 3 gets worse in the WR they call me and we upgrade them to a level 2. In no way should a triage level be etched in stone...

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Specializes in ED, Critical Care, Street Outreach.

Thanks for the replies. For those who do not change triage score how do you track acuity changes when it will be hours before the patient is seen?

Thanks

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