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Triage: How Urgent Is Your Case?
 

Triage: How Urgent Is Your Case?

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Triage is the process of sorting and determining patients’ priority depending on the severity of their conditions. The triage is commonly the picture of crash carts rolling across the room, patients howling in pain, blood splattering and orders being bellowed. It is a battle field, and the need to prioritize strategically and quickly is crucial in order to save a patient’s life.
 
today.mims.com
 
17 Jul 2016 - General
 
This reminds me of the pre-medical student days when we prepare for the interview for selection to enter medical school. There is always this question: Suppose you are an A & E physician and there is an 80 year old lady who is critically ill and a 5 year old boy who is also critically ill. Who would you treat first and why? Most students who do not have a clear understanding would say they will treat the 5 year old boy because he is younger and has a brighter future ahead. But a good answer ...
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Triage does not follow the principle of "first come, first serve" mainly because triaging is based on life and death situation. When a drunk patient comes in first and is the next patient to be attended by the physician or health care worker, then suddenly a dying patient is brought to the emergency room, then the drunk patient will be second in priority simply because he can still wait to be treated and isn't dying. In triage, there is color coding. When you are classified to be c...
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@Marinelle: I truly would like to see an institution that organized. Then again I have experienced such environments but with the downside of the space being too small to reach its full potential. Definitely the ER needs to be departmentalized. Does the situation remain the same after 5pm? Are all areas like the non-urgent manned 24 hours?

I believe the placement of the nurses station is vital as well. From experience, I have seen a nurse's station in the middle like an island, one...
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Hi Jennifer, in our institution, there are two separate emergency rooms. One for adult and one for pediatric patients. Both emergency rooms have a non-urgent, urgent and emergent sections. Those who are triaged in the non-urgent section are the usual out-patient cases such as cough, viral infections etc. These are manned by family physicians and emergency med specialists. Those who are triaged in the urgent areas are more toxic-looking patients presenting with abdominal pain, headache, fever etc...
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I like that idea of a patient liaison officer. This person would take a load off the ER staff and give comfort and assurance to the patients. We do try to explain to patients as much as we can but it being the ER where everything is fast pace there usually isn't any time to do so. We could squeeze in a "please be patient we will get your results soon" or the like but that cannot always be done. I have experienced going on duty as the ER physician and the physician in charge of the ...
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As Leothel has pointed out, proper effective communication and explanation from the emergency department staff to the patients and relatives about the settling in emergency department, and why some certain cohort of patients need to wait a bit longer, comparing to those patients who is suffering from acute medical emergency that required immediate attention from healthcare professionals. Lack of knowledge with regards to this process will always make them feels that “they are being treated unfa...
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The emergency room can be a high stress/ drama environment. High stress for the health care professionals, high drama for the patients and their guardians. I guess all the drama stems down from a lack of understanding of triage. Some non-health care people, maybe due to fear of not knowing what is happening, tend to get upset if they do not see a lot of "action" being done to them or their patients. Sometimes due to the high urgency and stress in the ER, proper communication and explan...
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So it turns out that the notion of 'All men are equal, but some men are more equal' exists in other countries apart from India!! It does happen that a certain patient will demand more attention in the casualty and providing that attention would be difficult in the face of a mass casualty or presence of several other life-threatening conditions which require priority.
While it is true that the emergency patient often requires early attention than the 'Important" person, it is...
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The triage process was longer for patients who were expected by specialties and/or triaged to specialties, although it might have been expected that they would be easier to sort as the pathway was predetermined. This process generally required supplementary phone communications which took considerable time, and although there was generally evidence that the general practitioner had recorded vital signs, the triage staff chose to repeat these and thus no time was saved. Although repetition of thi...
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@Jennifer, raising the public awareness with regards to this issues is always a good way to tackle it. Without any proper knowledge of how the running in emergency department will always lead to misunderstanding of why certain group of “not so sick or not so unwell” cohort of patients will need to wait for a much prolonged period of time before being seen by a doctor. And we can potentially advise that cohort of “not so sick or not so unwell, that require outpatient management” to attend their o...
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@Marinelle: I know what you mean. When they name drop and say they know this prominent person and that angers me a whole lot. It really makes my blood boil to the full extent of almost exploding. What about my other patients? They don't know anybody. Does this mean I should treat you first? I would tell them that they have to wait in line like everyone else and smile. I kill them with kindness. If they choose to go to the admin and take up their case there that is fine. As long as their case...
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I really like this “First come, first served” is not the motto of triage. Triage in emergency department can be a stressful job, as everyone who attended the emergency department want to be seen by a doctor and get treated as soon as possible. Everyone will perceived that they are the priority, but not others. From emergency department point of view, medical or surgical emergency, life threatening case, cardiac arrest, and trauma case will be given urgent priority and being treated and managed f...
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As health professionals, we know better. Most of the time, relatives who demand a lot are actually agonizing over not knowing what will happen to their patient. I won't deny the fact that it is annoying when a patient's relative tries to threaten you by name dropping a prominent figure in the hospital. More often than not, in these situations I cannot be kind because I find it rude for people to assume that I will set aside my principles just because they know somebody. We cannot deny th...
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"“First come, first served” is not the motto of triage."- As the article stated there will always be that patient. It is obvious that the drunk patient’s watcher didn’t get all the facts or he may have possibly been drunk as well. We need to remain calm in these situations not only to be able to select the right moves to help our patients but also we need to remain calm in dealing with the demanding ones. I have encountered countless cases of name dropping and “don’t you know who I am?...
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