A Visit to an Emergency Room

Triage: Classification of needs.

Triage is a process of classifying patient care needs based on severity of condition. When resources are insufficient for all incoming patients to be treated immediately this method of selection supports patient treatment by priority of illness or injuries. The modern approach to triage is consistent with physiological assessment findings and history taking.

Triage is the first stop in the Emergency Department. Vital information is recorded and an immediate assessment is made by a Registered Nurse (RN) to determine the patients triage classification:

Life threatening
Urgent
Less urgent

Many facilities have a separate triage for incoming rescues. To better facilitate bed control, non-emergent patients arriving by rescue are rerouted through the main triage area so they are not occupying a bed ahead of an emergent patient who may have driven themselves into the hospital.

Following triage a patient is assigned to an examination room and placed in a hospital gown. An RN is assigned as caregiver and a detailed history and physical examination is completed. The RN in the Emergency Department has great latitude and freedom of practice and may start initial treatment based on patient symptoms following preset guidelines issued by the facility: IV access, IV fluids, Lab tests, x-rays, electrocardiogram, etc.

A physician then examines the patient, reviews symptoms and documented history and makes a differential diagnosis. Treatment may be initiated at this time or may be withheld pending results of tests. When all of the results are received the Emergency Department physician makes a decision regarding most likely diagnosis and either orders specific treatment , additional tests, or consults a specialist. A determination is also made whether to treat the patient and discharge them home or admit patient as in-house patient for further testing and treatment.

A good triage nurse will keep the Emergency Department moving smoothly.