Ryan C. Mirano, MD, MHSA. Emergency Department Triage. The Evolution of Triage. Purpose of ED triage: To prioritize incoming patients and to identify those who cannot wait to be seen Three most common types of triage systems: Traffic director Spot-check Comprehensive triage.
crystalloid and colloid resuscitation
RR <10 or >30
Answer: ESI level 2: high risk. A 44-year-old diabetic with continuous vomiting is at risk for diabetic ketoacidosis. The patient's vital signs are a concern as her heart rate and respiratory rate are both elevated. It is not safe for this patient to wait for an extended period of time in the waiting room
Answer: ESI level 4: one resource. This young lady needs to have an incision and drainage of her paronychia. She will require no other resources.
Answer: ESI level 2: new onset confusion, lethargy, or disorientation. The daughter reports that her mother has a change in level of consciousness. The reason for her change in mental status may be a urinary tract infection that has advanced to bacteremia. She has an acute change in mental status and is therefore high risk.
Answer: ESI level 1: requires immediate lifesaving intervention. The patient is presenting with signs of shock-hypotensive, tachycardic, with decreased peripheral perfusion. He has a history of hypertension and is presenting with signs and symptoms that could be attributed to a dissecting aortic abdominal aneurysm. He needs immediate IV access, aggressive fluid resuscitation, and perhaps blood prior to surgery
Answer: ESI level 3: two or more resources. It looks like this patient has a displaced fracture and will need to have a closed reduction prior to casting or splinting. At a minimum, she needs x-rays and an orthopedic consult. Her vital signs are stable, so there is no need to up-triage her to an ESI level 2. Her pain is currently a 6/10.