triage-final.ppt

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EMERGENCY ROOM
PRESENTED BY :
MOHANNAD ALGHARAYBEH
Triage
Emergency Severity Index

2. Out Line :
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Definition of triage .
The personal abilities that are essential to be
an effective triage nurse
Daily triage in hospital setting .
Triage process .
What is ESI ?
ESI ALGORITHIM
Resources .

3. Objectives :
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At the end of this lecture , all audiences will be able to :
•Define the Triage and ESI .
•Classify the patients by using ESI on their level of
acuity .
•Expect how many resources needed for
patients to but them on there level .
•Differentiate between resources and
non-resources on your hospital .

4. Definition of triage
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It is the process which places the right
patient in the right place at the right time to
receive the right level of care.
Accurate triage allow the nurse to do
the greatest good for the greatest number of
afflicted .

5. The personal abilities that are essential to be an effective
triage nurse
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Clinically experience .
Good judgment and leadership .
Calm and cool under stress.
Knowledgeable of available resources .
Creative problem solver .
Availability .
Experienced and knowledgeable

6. Daily Triage in Hospital Setting:
Nurses perform daily triage on a routine
bases every day in the emergency
department .
The purpose :
Is to identify those patient who have the
highest degree of compromise for the purpose of
providing rapid care to the sickest patient
first .

7. Triage Process
1-Gathering information at point of triage . “ AMPLE”
2-Perform initial assessment ( assessment sheet )
at point of triage . “Primary survey”
The goal of triage process :
togathersufficient data for
determining acuity and identify
immediate needs .
Triage process should be completed within 5
minutes.

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What is ESI?
Emergency Severity Index
A five level triage scale that uses prioritization based
on urgency (acuity) of condition but also considers
resources needed to get the patient thru to ED
disposition.
Rapid, accurate triage is key to successful emergency
department operations.

9. What is ESI?
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Undertriageleaves a patient at risk for
deteriorating while waiting. Overtriageuses
scarce resources limiting availability of an open
ED bed for another more critical patient.
Initial triagemust be accurate.
ESI is a tool for Emergency Department Triage.
The Algorithm yields rapid, reproducible, and clinically
relevant stratification of patients into five groups-from
Level 1 (Most urgent) to Level 5 (least urgent).

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So, a 5 Level rating?
5 levels have meaningful differences between
each level compared to previous 3 Level
systems.
ESI levels can be used to describe acuity levels.
ESI levels can be used to describe acuity of
patients.

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Emergency Severity Index
ESI
• Acuity assessment
-Airway, breathing, circulation
-Potential for life, organ or limb threat
-How soon the patient needs to be seen
• Expected resource assessment
-Number of resources, as estimated by the
triage nurse, that a patient is expected to
consume in order for a disposition decision.

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ESI ALGORITHIM

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•An experienced triage nurse is able to
recognize a patient in extremis with an
across the room brief assessment.
•Level 1 patients comprise 1-3% of all ED
patients.

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24. Decision Point B
is this a high risk situation?
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The nurse utilizes experience to identify a patient
at High Risk.
ESI level 2 patients are a high priority and
placement and treatment should begin within 10
minutes of arrival.

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Resource Examples
CBC,BMP, PT/PTT=One Resource
CBC, CXR=Two Resources
CXR, ABD Series=One Resource
CXR,CT Scan=TwoResources
CBC,CT Scan, EKG=ThreeResources

35. ESI Level 5
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No resources .
Examples :
healthy 52 year oldv who ran out of his blood
pressure medicine yesterday .
22 year old , involved in a car accident 2 days ago ,
wants to be checked . Nothing hurts .
46 year old with a common cold .

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42. Summary
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Resources
•Emergency Severity Index (ESI) A Triage Tool for Emerge
ncy Department Care Version 4