Emergency Room Triage Protocol

The difference between life and death can be measured in minutes, if not seconds, in emergency rooms. In order to give every patient the best chances of recovery, the practice of triage is used. From the French, meaning to sort, triage is the act of prioritizing patients to ensure maximum chances of survival.

Function

• The purpose of triage is to move the most critically wounded patients to the front of the line. With limited resources in hospitals (beds, staff, etc), it is important to ensure the most good is done with what is available. This is particularly true in incidents with multiple patients. For example, a train wreck might have dozens of victims and it is vital to ensure those with the most life-threatening injuries are treated first.

History

• Using heicopters to transport wounded increased their chances of survival

  The concept of triage was believed to have originated in Napoleonic times. According to Dr. Glenn Mitchell in his paper "A Brief History of Triage," Napoleon's surgeon Baron Dominique-jean Larrey established not only the beginnings of triage methodology but the first version of ambulance service. Historically, times of war have seen improvement in emergency medicine. With the use of helicopters to transport wounded in the Korean War, the mortality rate of soldiers wounded in battle fell below 30 percent. With improving technology and triage practice, by the time of the conflicts in Iraq, that number reached 10 percent.

Considerations

• The three types of injury used to classify patients are emergent, urgent and non-urgent. These are also color coded as red, yellow, and green and are based on the patient's status. Emergent patients are usually incapable of communication or voluntary movement. They receive the highest priority. Urgent injuries are not immediately life-threatening but need to be treated with some haste -- patients are usually conscious and capable of some movement. Non-urgent injuries allow the patient to move and communicate.

Time frame

• In modern times, triage begins before the patient arrives at the hospital. Paramedics will communicate their patient's condition to the hospital staff, allowing them to prepare for arrival while administering first aid. In instances of multiple patients, paramedics can alert the hospital staff to the number of victims and their status, allowing them to plan ahead and organize staff and resources. Once they have arrived, hospital staff take over and prioritize the patients.

Benefits

• In times of mass admissions, triage is invaluable is saving lives. In circumstances with multiple patients, terrorist attacks or natural disasters, for instance, hospital staff must decide how their limited resources can be used best. Simply put, proper triage practices can save lives and increase the chances of the patient not only surviving but recovering fully. Timely treatment of injuries can prevent permanent damage such as loss of limbs and other long-term effects.