The word Triage comes from the French word trier, which means "to sort". During a mass casualty or disaster, triage is used to determine how time and resources should be used. If a person is found with no breathing or heartbeat, he would be given the classification "E" - expectant, and sadly, left to die. A victim with massive bleeding and spontaneous breathing wound be classified as "I", immediate, whose life could be saved if given prompt treatment. A victim with an obvious broken arm but no bleeding and no breathing difficulties would be given a "D", delayed, an obvious meaning. The walking wounded - scrapes and bruises would be "M" - minimal and could wait indefinitely.
In day-to-day life, in the absence of disaster, triage is used in the emergency department to decide who will see the doctor first. My hospital, like many, uses a 5 tiered system. "5" is given to a Patient coming in for suture removal or the recheck of a wound. A patient with a sore throat or cold would be given a "4" and could wait a long time with no harm done. The person with nausea and vomiting, abdominal pain, or a broken arm wound be given a "3" which means they need to be treated as soon as possible, but there is no imminent danger to their life or limb. The man who comes in looking pale, sweating, and clutching his chest, complaining of chest pain would be given a "2" - needing of immediate treatment or there could be a threat to life. We reserve the rating of "1" for the patient that EMS brings in with CPR in progress or a person with stroke symptoms prior to complete unresponsiveness.
Working as a Triage Nurse can be a stressful position. In my department, certain nurses are routinely placed in triage for the day while most of the staff do direct patient care. The charge nurse relies on the triage nurse to keep things moving and to alert her when a patient has arrived who needs an immediate exam room open, but who won't bother her with multiple questions or updates. During a busy day, the triage nurse is also responsible for the patients in the waiting room who may be there for hours. The lady who comes in with abdominal pain may seem stable, but an hour later could become diaphoretic and pale with a decreased level of consciousness due to a rupturing aneurysm. That is the responsibility of the triage nurse to monitor. This can be overwhelming with 15-20 people waiting. Then there is dealing with the angry glares and multiple trips to the front desk from the man with the sore throat who sees the patients with chest pain and trouble breathing going first. The average citizen does not understand triage and assume they will get in to see the doctor in a similar fashion that they would get a table at the Outback.
The addition of urgent care centers has greatly reduced the number of patients coming in for minor ailments, but with the current health care crisis, many still rely on the ER for their needs because they have no insurance and cannot pay the up-front cost of an urgent care. So next time you find yourself waiting in the ER, even if you're uncomfortable, give the triage nurse some credit that she is not ignoring you or playing favorites when she wheels the semi-conscious patient into the back who came in after you did.
In day-to-day life, in the absence of disaster, triage is used in the emergency department to decide who will see the doctor first. My hospital, like many, uses a 5 tiered system. "5" is given to a Patient coming in for suture removal or the recheck of a wound. A patient with a sore throat or cold would be given a "4" and could wait a long time with no harm done. The person with nausea and vomiting, abdominal pain, or a broken arm wound be given a "3" which means they need to be treated as soon as possible, but there is no imminent danger to their life or limb. The man who comes in looking pale, sweating, and clutching his chest, complaining of chest pain would be given a "2" - needing of immediate treatment or there could be a threat to life. We reserve the rating of "1" for the patient that EMS brings in with CPR in progress or a person with stroke symptoms prior to complete unresponsiveness.
Working as a Triage Nurse can be a stressful position. In my department, certain nurses are routinely placed in triage for the day while most of the staff do direct patient care. The charge nurse relies on the triage nurse to keep things moving and to alert her when a patient has arrived who needs an immediate exam room open, but who won't bother her with multiple questions or updates. During a busy day, the triage nurse is also responsible for the patients in the waiting room who may be there for hours. The lady who comes in with abdominal pain may seem stable, but an hour later could become diaphoretic and pale with a decreased level of consciousness due to a rupturing aneurysm. That is the responsibility of the triage nurse to monitor. This can be overwhelming with 15-20 people waiting. Then there is dealing with the angry glares and multiple trips to the front desk from the man with the sore throat who sees the patients with chest pain and trouble breathing going first. The average citizen does not understand triage and assume they will get in to see the doctor in a similar fashion that they would get a table at the Outback.
The addition of urgent care centers has greatly reduced the number of patients coming in for minor ailments, but with the current health care crisis, many still rely on the ER for their needs because they have no insurance and cannot pay the up-front cost of an urgent care. So next time you find yourself waiting in the ER, even if you're uncomfortable, give the triage nurse some credit that she is not ignoring you or playing favorites when she wheels the semi-conscious patient into the back who came in after you did.
