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THE CANADIAN TRIAGE.pdf
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  1. 1. 1 E M E R G E N C Y R O O M P R E S E N T E D B Y : M O H A N N A D A L G H A R A Y B E H Triage Emergency Severity Index
  2. 2. Out Line : 2  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. 3. Objectives : 3 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. 4. Definition of triage 4  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. 5. The personal abilities that are essential to be an effective triage nurse 5  Clinically experience .  Good judgment and leadership .  Calm and cool under stress.  Knowledgeable of available resources .  Creative problem solver .  Availability .  Experienced and knowledgeable
  6. 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. 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 : togather sufficient data for determining acuity and identify immediate needs .  Triage process should be completed within 5 minutes.
  8. 8. 8 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. 9. What is ESI? 9  Undertriage leaves a patient at risk for deteriorating while waiting. Overtriage uses scarce resources limiting availability of an open ED bed for another more critical patient. Initial triage must 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).
  10. 10. 10 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.
  11. 11. 11 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.
  12. 12. 12 ESI ALGORITHIM
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  20. 20. 20 • 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. 24. Decision Point B is this a high risk situation? 24  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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  34. 34. 34 Resource Examples  CBC,BMP, PT/PTT=One Resource  CBC, CXR=Two Resources  CXR, ABD Series=One Resource  CXR,CT Scan=Two Resources  CBC,CT Scan, EKG=Three Resources
  35. 35. ESI Level 5 35  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. 42. Summary 42
  43. 43. 43 Resources • Emergency Severity Index (ESI) A Triage Tool for Emerge ncy Department Care Version 4

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