Triage is a process of prioritizing the severity of a patient’s condition and the following urgency of treatment. The priority of patient treatment is an important part of receiving patients in the emergency department. You only have a certain amount of rooms, hands and time and therefore it’s important to make a conscious decision about treatment of each patient. In an emergency situation there are not always one correct decision, but you have to be aware of your decisions, since it might affect the next person who comes in.
The triage system that we use for this summer school is a system called Danish Emergency Process Triage (DEPT)*. The system categorizes patients into five categories based on severity. The categories determine which patient should be seen first and how often the patient should be reassessed.
The categories are as follows:
Red Life-threatening condition. immediate action (0 min.) and continuous monitoring
Orange Critical condition. Action within 15 min
Yellow Stable condition, however potentially unstable. Action within 60 min.
Green Stable condition. Action within 180 min.
Blue Non-urgent condition. Action within 240 min.
These categories are used in the form of triage cards that describes the reason for contact (poisoning, GI bleeding, head injury etc.). Each card describes how you should triage the patient depending on your findings.
Normally these findings would normally be vital parameters and other preliminary information given to you by the triage nurse.
* We operate with a modified version of DEPT. We have limited the number of triage cards to 32 to better fit the limits of a short introductory workshop. Furthermore we have translated the system from Danish to be able to use it at an international setting.
THE TRIAGE BOOKLET
Ressources and further reading:
Barfod C, Forberg JL. Prediction of 7 days mortality in a general population admitted to Emergency Department. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2012;20(Suppl 2):P40. doi:10.1186/1757-7241-20-S2-P40.
Barfod C, Lauritzen MMP, Danker JK, et al. The formation and design of the “Acute Admission Database”- a database including a prospective, observational cohort of 6279 patients triaged in the emergency department in a larger Danish hospital. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2012;20:29. doi:10.1186/1757-7241-20-29.
Barfod C, Lauritzen MMP, Danker JK, et al. Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department – a prospective cohort study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2012;20:28. doi:10.1186/1757-7241-20-28.
Eiset AH, Erlandsen M, Møllekær AB, Mackenhauer J, Kirkegaard H. A generic method for evaluating crowding in the emergency department. BMC Emergency Medicine. 2016;16:21. doi:10.1186/s12873-016-0083-4.
Forberg JL, Barfod C. Emergency Department presenting complaints associated with high mortality and the need for intensive care. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2012;20(Suppl 2):P16. doi:10.1186/1757-7241-20-S2-P16.
Plesner LL, Iversen AKS, Langkjær S, et al. The formation and design of the TRIAGE study – baseline data on 6005 consecutive patients admitted to hospital from the emergency department. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2015;23:106. doi:10.1186/s13049-015-0184-1.