By: Bell Law Firm
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Triage: How the First Stop at the ER Determines Patient Priority
Triage is the process of sorting and prioritizing patients for care. Because the process determines a patient’s place “in line” at the ER, it is important to understand and pay attention to your triage score.
What Does Triage Mean?
The term refers to the sorting of sick or injured patients according to their need for emergency medical attention. Triage is thus the method hospital emergency departments use to determine who gets care first.
How Does It Work?
When a patient arrives, an ER nurse performs a brief, focused assessment and assigns the patient a triage acuity level, also known as a “triage score.” The acuity level is a proxy measure of how long the patient can safely wait for medical evaluation and treatment. Because the score can determine how fast a patient is seen by a doctor and even what type of care the patient receives, a triage nurse must accurately assign, document, and report the patient’s acuity level.
What are the Triage Acuity Levels?
The Emergency Severity Index (ESI) stratifies patients into five acuity groups:
Level 1 (resuscitation) requires immediate, life-saving intervention. Level 1 includes patients with cardiopulmonary arrest, major trauma, severe respiratory distress, and seizures.
Level 2 (emergent) requires an immediate nursing assessment and rapid treatment. Level 2 includes patients who are in a high-risk situation, are confused, lethargic, or disoriented, or have severe pain or distress, including patients with stroke, head injuries, asthma, and sexual-assault injuries.
Level 3 (urgent) includes patients who need quick attention but can wait as long as 30 minutes for assessment and treatment. Level 3 includes patients with signs of infection, mild respiratory distress, or moderate pain.
Levels 4 and 5 are considered “less urgent” and “non urgent,” respectively.
What to Do?
The accuracy of the acuity level is critical because it determines the care the patient subsequently receives and the urgency with which it is provided. Sometimes ER nurses just get the triage score wrong. As a result, patients get placed further back “in the line” than their condition requires.
If you have the misfortune of finding yourself at the ER, you should ask for your triage score. If the score seems “off,” ask the nurse about the basis for the score, and if necessary, double-check with the charge nurse or with the attending physician.
The Bell Law Firm represents clients who have suffered death or catastrophic injury in medical malpractice and other personal injury cases.