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Triage in the ED, References Ignatavicius, D., Workman, L., Rebar, C.,…
Triage in the ED
emergent, urgent and nonemergent triage model
crushing substernal chest pain, SOB, and diaphoresis - would be classified as emergent and triaged immediately
critcally injured trauma patient or person with active hemorrhage - emergent
emergent - implies that a condition exists that poses an immediate threat to life and limb
urgent - indicates that the patient should be treated quickly but that an immediate threat to life does not exist at the moment
examples - new onset of pneumonia, renal colic, complex lacerations, displaced fractures or dislocations, and temp higher than 101
reassessment is needed if the care provider cannot evaluate the patient in a timely manner, in the case of clinical deterioration, triage priority may be upgraded from urgent to emergent
non urgent - tolerate waiting several hours for heath care services without significant risk for clinical deterioration
examples - sprains, strains, simple fractures, rashes, UTIs
using the ABC approach to triage is good for determining if a patient falls in urgent or emergent
either a RN, physician, PA or NP will perform a rapid assessment to determine the triage priority
the triage nurse needs appropriate training and exerience in both emergency nursing and triage decision-making concepts
emergent triage - 3 tiered triage scheme, the category that includes any condition or injury that poses an immediate threat to life or limb such as crushing chest pain or active hemorrhage
triage is a system for sorting or classifying patients into priority levels, depending on illness or injury severity
patients in the ED with highest acuity needs receive the quickest evaluation, treatment, and resource utilization (x-rays, lab work, CT), operating rooms, cath lab
a person with a lower acuity level may have to wait longer than a higher acuity level
emergency nurses are in a good position to provide education to patients coming in, especially non-urgent patients who's condition could be treated in an urgent care or with an appointment with a PCP
they can also provide good education about how to care for issues at home, and how to prevent a readmission with the same problem
after triage in the ED the provider must decide if the patient should be admitted to the hospital, or sent home. If admitted the provider has to decide what floor they want the patient on.
References
Ignatavicius, D., Workman, L., Rebar, C., & Heimgartner, N. (2021). Medical-surgical nursing: Patient-centered collaborative care.
Evolve
, (10th ed.). ISBN: 978-0-323-61242-5
Holman, H. C., Williams, D., Johnson, J., Ball, B. S., Wheless, L., Leehy, P., & Lemon, T. (2019). RN Adult medical surgical nursing: Review module. Assessment Technologies Institute