Triage categories
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So patients when they present to triage, when you triage them, they fall under different categories. How does that work?
We discussed it around that when you take your triage observations of the patient and you enter them into the documentation screen, you then will scroll down and you will select the presenting complaint. And I just want to explain this to you, so if we select on that, let us say the patient came with a rash, which looks straightforward. But then when you select after questioning the patient they suggest that they feel as though their airway's compromised. If you select "airways compromised", that will convert that immediately to an immediate response, a red category, which needs to be seen zero minutes, so straight away, that patient will need to be taken around to the resuscitation area in this hospital.
If it is not immediate, the next category down would be a very urgent case and this would be an orange patient. And depending on what you pick as a discriminator, this would then convert the triage category to "very urgent". This is a 10-minute response. In our hospital here this patient would be seen around on the majors unit. Again, we would need to ring around to make sure there is a cubicle available for this patient. This could be a patient, for example, who has got an active bleed, this could be a significant external or query GI bleed. We could send that patient around to there. A patient who has got a significant pain score, for example, a pain score of 8 and above, we could send them around to majors because they may need some IV analgesia. So that is the next category.
The next one down would be yellow. That would be within 60 minutes. So this is less severity of illness for the patient and this patient could be seen around on either majors or green ambulatory. We may also consider ringing the ambulatory emergency centre to see if they could take certain categories of patients, such as cellulitis, who may require some IV antibiotics, pleuritic chest pain, not cardiac in origin.
And then the next category down, Mark, would be standard, okay. This is 120 minutes. This patient would be less acuity of presenting complaint. It could be a patient who has been sent in by the GP, patient with a minor injury, not a suitable referral to a walk-in centre but has got a low pain score, so may not need IV analgesia straightaway. In our hospital we will send this patient around to the green ambulatory area.
And then finally, the last category would be non-urgent, so 240 minutes to be seen, that's the target. Not always appropriate for this patient to remain in the emergency department and be seen. It may be they can be sent to community services, referred back to their own GP for review, or actually go to minor injuries or walk-in centre. And that's all the categories explained. In other hospitals, it is exactly the same process. The triage categorisation does not change what the outcome or the time response is. It is exactly the same whichever hospital it is. It is just that in other hospitals, they may have a different area designated for that, but it will always be a resuscitation area, takes the red patient straightaway.
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