Tornados, cyclones, hurricanes and other severe storms and flooding Explosions and bomb threats Radiation contamination and Acts of terrorism and bioterrorism in the health care facility External disasters are serious events which occur in the nearby community that leads to mass causalities and people in need of medical attention and care.
Types[ edit ] Vital signs defining the colour-coded triage. Glasgow Coma Score; Tp: Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department.
This section is for concepts in triage. See other sections for specific triage tools, methods, and systems Simple triage[ edit ] Simple triage is usually used in a scene of an accident or " mass-casualty incident " Role of triage in emergency carein order to sort patients into those who need critical attention and immediate transport to the hospital and those with less serious injuries.
This step can be started before transportation becomes available. At its most primitive, patients may be simply marked with coloured flagging tape or with marker pens. Pre-printed cards for this purpose are known as a triage tags. Triage tag A triage tag is a prefabricated label placed on each patient that serves to accomplish several objectives: Triage tags may take a variety of forms.
Some countries use a nationally standardized triage tag,  while in other countries commercially available triage tags are used, and these will vary by jurisdictional choice. Some of these tracking systems are beginning to incorporate the use of handheld computers, and in some cases, bar code scanners.
Advanced triage[ edit ] For classifications, see the specific section for that topic. In advanced triage, doctors and specially trained nurses may decide that some seriously injured people should not receive advanced care because they are unlikely to survive.
It is used to divert scarce resources away from patients with little chance of survival in order to increase the chances for others with higher likelihoods. The use of advanced triage may become necessary when medical professionals decide that the medical resources available are not sufficient to treat all the people who need help.
The treatment being prioritized can include the time spent on medical care, or drugs or other limited resources. This has happened in disasters such as terrorist attacksmass shootingsvolcanic eruptionsearthquakestornadoesthunderstormsand rail accidents.
In these cases some percentage of patients will die regardless of medical care because of the severity of their injuries. Others would live if given immediate medical care, but would die without it.
In these extreme situations, any medical care given to people who will die anyway can be considered to be care withdrawn from others who might have survived or perhaps suffered less severe disability from their injuries had they been treated instead.
It becomes the task of the disaster medical authorities to set aside some victims as hopeless, to avoid trying to save one life at the expense of several others. If immediate treatment is successful, the patient may improve although this may be temporary and this improvement may allow the patient to be categorized to a lower priority in the short term.
If a record is maintained, the receiving hospital doctor can see a trauma score time series from the start of the incident, which may allow definitive treatment earlier. Continuous integrated triage[ edit ] Continuous integrated triage is an approach to triage in mass casualty situations which is both efficient and sensitive to psychosocial and disaster behavioral health issues that affect the number of patients seeking care surgethe manner in which a hospital or healthcare facility deals with that surge surge capacity  and the overarching medical needs of the event.
Continuous integrated triage combines three forms of triage with progressive specificity to most rapidly identify those patients in greatest need of care while balancing the needs of the individual patients against the available resources and the needs of other patients.
Continuous integrated triage employs: Group Global Triage i. Reverse triage[ edit ] Usually, triage refers to prioritising admission. A similar process can be applied to discharging patients early when the medical system is stressed. This process has been called "reverse triage".
In order to accommodate a greater number of the new critical patients, the existing patients may be triaged, and those who will not need immediate care can be discharged until the surge has dissipated, for example through the establishment of temporary medical facilities in the region.
Undertriage and overtriage[ edit ] Undertriage is underestimating the severity of an illness or injury. An example of this would be categorizing a Priority 1 Immediate patient as a Priority 2 Delayed or Priority 3 Minimal.
Overtriage is the overestimating of the severity of an illness or injury. An example of this would be categorizing a Priority 3 Minimal patient as a Priority 2 Delayed or Priority 1 Immediate.
Some studies suggest that overtriage is less likely to occur when triaging is performed by hospital medical teams, rather than paramedics or EMTs.
For specific triage systems and methods see the sections dedicated to that topic. Palliative care[ edit ] For those patients that have a poor prognosis and are expected to die regardless of the medical treatment available, palliative care such as painkillers may be given to ease suffering before they die.
In the field, triage sets priorities for evacuation or relocation to other care facilities. Examples include schools, sports stadiums, and large camps that can be prepared and used for the care, feeding, and holding of large numbers of victims of a mass casualty or other type of event.
While hospitals remain the preferred destination for all patients, during a mass casualty event such improvised facilities may be required in order to divert low-acuity patients away from hospitals in order to prevent the hospitals becoming overwhelmed.The role of an emergency room nurse can be demanding and may require a nurse to use many different nursing skills at certain times to take care of a variety of patients.
The main role is the nurse must be skilled in client assessment, priority setting, critical thinking, multitasking, and communication.
Simply being an RN will qualify you for the triage title, but having a certification can get you more attention. There is not a specific triage nursing certification, but becoming a Ambulatory Care Nurse can help show you are a specialist in emergency care.
Triage is used when the medical-care system is overloaded, meaning there are more people who need care than there are available resources to care for them. There may be mass casualties in a war zone, terrorist incident, or natural disaster that results in many injuries.
Learn emergency and trauma nursing with free interactive flashcards. Choose from different sets of emergency and trauma nursing flashcards on Quizlet. The role of Emergency Medicine Physicians (EMP) in the care of trauma patients in North America has evolved since the advent of the specialty in the late 's.
Unlike all other centres in North America that employ physician and primarily nurse triage models, this hospital began the practice of employing Primary Care level paramedics to perform triage upon entry to the Emergency Department. In , following the amalgamation of two of the city's largest hospitals, the Emergency Department at the.