Triage.pptx

TRiage

1. T ri a ge W a i ting r oom T e a m l ea d e r Triage in Emergency Department

2. Meaning of TRIAGE T : Targeting R : Relativity I : Intervals A : Analytics G : Grouping E : Explorer

3. • I t’s the p r o ce ss by wh i c h pat i e n t s c l a s si fi ed a cc o r ding to t h e type a nd urg e ncy o f the i r cond i t i ons t o g e t the R i ght R i ght R i ght R i ght p a t i e nt to the p l a ce a t the t i me wi t h the care provi d e r Triage is the term derived meaning to sort or to choose. Definition of Triage

4. N o n di s a s te r : To provi d e the b e st ca r e f or ea c h i nd i v i d u a l pat i ent. M ul t i c a sua l t y /dis a s t e r : To prov i de the most ef f ect i ve care f o r the g r ea t e st n u mb e r of pa t ients. • • Triage Categories

5. D e f i n i ti o n: a n i nc i d e n t, e i t h e r n a tu ral or h u m an- m a d e , t h a t p r o d u c e s p a t i e n ts i n n u m b er s n e e d i n g ser v i c e s b e y o nd i m m e d iat e ly a v a i l able r e so u r c e s . May i n vo l v e a l a r ge n o. of p ati e n ts or a s m a l l n o. of pat i e n ts if t h e ir n ee ds p l ac e s ign i f icant d e m an d s o n r es o u r c es . T h e k e y t o s u cc es s f u l d i sa s t e r m anag e m e n t is t o p r o v i d e c a r e to t h o s e w h o a r e in g r e at es t n ee d f i r s t a n d ju s t a s i mp o r tan t l y , n ot p r o v i de ca r e t o t h o se w h o h a v e l i t t le or no c h ance of s u r v i v a l . C or r e c t t r ia g e i s e s s e ntial to acc o mp l i s h this g o al • • Disaster

6. Color Coding for T r i age LEVEL COLOR Coding 1. Immediate Red 2. Delayed Yellow 3. Minimal Green 4. Expectant Black

7. Triage in Emergency Department Emergent (Red):Priority1 (Highest) This classification is assigned to clients who have life-threatening injuries and need immediate attention and continuous evaluation but have a high probability for survival when stabilized. Such clients include trauma victims, clients With chest pain, clients with severe respiratory distress or cardiac arrest, clients With limb amputation, clients with acute neurological deficits, and clients Who have sustained chemical splashes to the eyes. Urgent (Yellow): Priority 2 This classification is assigned to clients Who require treatment and whose injuries have 1 complications that are not life-threatening, provided that they are treated within 30 minutes to 2 hours these clients require continuous evaluation every 30 to 60 minutes thereafter. Such clients include clients with an open fracture with a distal pulse and large Nonurgent (Green): Priority 3 This classification is assigned to clients With local injuries who do not have immediate complications and who can wait at least 2 hours for medical treatment; these clients require evaluation every 1to 2 hours thereafter. Such clients include clients with conditions such as a closed fracture, minor lacerations, sprains, strains, or contusions. Priority 4. a triage systems include tagging a client Black if the victim is dead or soon Will be deceased because of severe injuries; these are victims that Would not benefit from any care because of the severity of injuries.

8. 1-Resuscitation 2-Emergent 3-Urgent 4-Less urgent 5-Non urgent Triage Levels

9. Triage Levels 1- Resuscitation -- threat to life/limb Time to nurse assessment IMMEDIATE Time to physician assessment IMMEDIATE • Cardiac and respiratory arrest • Major trauma • Active seizure • Shock • Status Asthmaticus 1

10. 2 - E m er ge n t P o t e n t i a l t h r e a t t o li fe , l i mb o r f u n c t ion N u r s e I mm e d i a t e , P h ys ician < 1 5 m i n u t e s • • • • • • • De c r e a se d l eve l o f c o n s c i o u s n es s S eve re r e s p i r ato r y d i s t r e s s C h es t pain wi t h ca r d iac s u s p i c i o n Ov e r d o s e ( CONSC I O US ! ) S eve re a bd o m i n a l p a i n G. I . Bl e e d w i th ab n o r m a l v i tal s i gns C h e m i c a l ex p o s u r e to ey e Triage Levels 2

11. 3- U r g ent C o n d i t ion w i th s i gni fi c a nt d i stress T i me: N u r s e < 20 m in, phys i c i a n < 30 min • H e a d i n jury wi t ho u t d e cr e a se of L O C but w i th vom i t i ng M i l d to mode ra te r e sp i r a to r y d i st r e ss G . I . B l e e d not a ct i v e l y ble e d Acute psychos i s • • • Triage Levels 3

12. 4- Less u r g e nt C ond i t i o ns w i th mi ld t o m oder a te T i m e f or N urse a ssess m e nt < 1 h d i sco mf ort T i m e f or phys i c ia n a ssess m ent < 1h H ead i njury, a l e r t, no vom i t i ng C h e s t pa i n, no d i s t r e s s, n o card ia c susp. D e press i on wi t h no s uic i dal a t t e mpt Triage Levels 4

13. 5- N on urgent C o n d i t ions can be de l a y e d, no d i s tr e s s T i me for nurse a nd P hys i ci a n a s s e ss m e nt mo r e th a n 2h • • M inor t r a u m a S o r e th r oat w i th te m p. < 39 Triage Levels 5

14. An “ a c ross the ro o m a ss es s m e n t” To i d e nt i f y o bv i ous li fe Gener a l a ppear a nce th r ea t cond i t i ons D i sa bility ( n e urog e ni c ) A ir w a y C i r c ul a tion B r e a t h ing Across the room assessment

15. • A i r w a y Ab n o r m a l a i r w a y sounds, str i der, w h ee zi ng grunt i ng Unusu a l p o s tu r e e .g . . Sn i f f i ng pos i t i o n , i nab ili ty to s p ea k , droo li n g or i n a bi li ty to h a n d l e s e cret i o n • B r e a th i ng A l t e red s ki n s i g n s, c y a nos i s, d u s ky s ki n, tach y p n e i c b r a dypne a , or a pnea p e ri o ds, ret ra c t i ons, use a c cesso r y m usc l es, n a s a l fl a r ing, grunt i ng, or a ud i b l e wh ee z es Across the room assessment

16. Ci rcul a t i on • A l te r ed s k in s igns, pa l e, m o t t l ing, Uncont r ol l ed ble e d i ng f lu s hing • D is a b i l i ty (n e u ro.) L OC I nte r a ct i on w i th en v ir o n m e nt I nab ili ty to reco g n i z e f a m il y memb e r s Unusu a l i r r i ta b i li ty Response t o p a in or st i mu l i F l ac cid o r hyper a c t i ve m usc l e t o n e Across the room assessment

17. • • • Gree t p a t i e n ts and i d e n t i f y h erse l f . M a i n t a i n p r i v a c y a n d c o n f i d e n t ial i ty V i s u a l i z e all i n c o m i ng pat i e n ts e v e n wh i le i n t e r v i e w i ng ot h ers . M a i n t a i n good c o mm u n icat i on b e twe e n t r i a g e t r e at m e n t a re a • a n d • m ai n tain ex c e l l e n t c o m mu n i ca t i o n w i th w a i ti n g a re a . U s e all res o u r ce s to m a i n t a i n h i gh s t a nd a r d of ca re . • Role of triage Nurse

18. • Tea c h i ng - -- - - use o f the rm o m e te r , f ir st a id ? ? ? a vo i d l ectu r i n g . • • • C rowd c ont r o l . Telephone. C ommun i cate w i th t ea m f e ed ba c k on dec i s i o n s . l ea der a n d s ee k Role of triage Nurse

19. Thanks You