Free Essay

How to Use a 5-Level Triage System

In: Other Topics

Submitted By adena702
Words 1031
Pages 5
How to Use a 5-level Triage System
Western Governors University

Topic: The importance and application of a 5-level triage system.

Attention Getter: I am currently a Charge Nurse in the busiest emergency room in Nevada. We see an average of 300 patients a day with wait time in the lobby upwards of 12-14 hours.
Purpose: The purpose of my presentation is to inform. I want my audience to understand why a 5-level triage system is best practice and I want my audience members to have a basic understanding of a 5-level triage system and to be able to begin training in an ER triage setting.

Audience: The ideal audience for my presentation are nurses that are newly graduated or new to the ER setting. My topic is specific for my intended audience and is beneficial for them. This presentation can be easily altered to address nurses that will be working in a pediatric ER.

Significance: The ability to correctly triage a patient in an ER is crucial to patient safety and patient care. In a busy ER patients generally have to wait to be taken out of the waiting area. A triage nurse needs to be able to sort through the patients and decide who the priorities are. The intended audience will become the nurses making these decisions.

Thesis Statement: Research shows that a 5-level triage system is best practice because ESI and CTAS provide dependability and reliability and because the implementation of a standardized ER triage process improves patient care.

I. First Main Point: A 5-level triage system is best practice because ESI and CTAS provide dependability and reliability.
A. Previous triage systems broke levels down to Emergent, Urgent, and Non-Urgent. These previous systems had less standardization then the 5-level ESI system.
B. Chart reviews revealed that there was rarely any correlation between triage acuity assignments and patient outcomes: patients triaged as Non-Urgent were admitted sometimes; patients triaged into a higher acuity category of Emergent or Urgent were often discharged. The triage acuity was often assigned with no clear clinical indication for the level, and the nursing documentation to support the assigned triage level was also lacking. Therefore, patient outcomes and resource utilization could not be anticipated on the basis of triage level. (Daniels, 2007, p. 59)
C. According to a study done of ER professionals in 2010 they were very satisfied with ESI. They indicated that ESI is more accurate than other triage algorithms and reduces the subjectivity of triage.(Singer, Infante, Oppenheimer, West, & Siegel, 2012, p. 120)
II. Second Main Point: Learning a 5-level ESI triage process to improve patient care.
A. ESI Levels 1-5
a. Level 1 patients are patients that are in cardiac/respiratory arrest or require any life-saving interventions immediately.
b. Level 2 patients are patients that are in a typically high risk situation. For instance – chest pain, altered mental status, psychiatric conditions requiring supervision, and severe pain.
c. Level 3-5 patients are decided based on resources. Level 5 uses no resources, Level 4 uses one resource, and Level 3 requires multiple resources.
d. The Triage Algorithm shows how to triage patients using chief complaint, vital signs, and resources needed. It also shows pediatric considerations for triage.

Resources Not Resources
• Labs (blood, urine).
• ECG, X-rays.
• CT-MRI-ultrasound-angiography. • History & physical (including pelvic).
• Point-of-care testing.
• IV fluids (hydration). • Saline or heplock.
• IV or IM or nebulized medications. • PO medications.
• Tetanus immunization.
• Prescription refills.
• Specialty consultation. • Phone call to PCP.
• Simple procedure =1 (lac repair, foley cath).
• Complex procedure =2 (conscious sedation). • Simple wound care (dressings, recheck).
• Crutches, splints, slings.
D. Danger Zone Vital Signs. Consider uptriage to ESI 2 if any vital sign criterion is exceeded.
Pediatric Fever Considerations:
1. 1 to 28 days of age: assign at least ESI 2 if temp >38.0 C (100.4F).
2. 1-3 months of age: consider assigning ESI 2 if temp >38.0 C (100.4F).
3. 3 months to 3 yrs of age: consider assigning ESI 3 if: temp >39.0 C (102.2 F), or incomplete immunizations, or no obvious source of fever.
(ESI Triage Research Team, 2014, Appendix B)

Summary: In summary, hospitals that have implemented a 5-level triage system have had better patient outcomes. Triage nurses throughout an emergency room can now consistently assign a triage level that is appropriate for patient care and outcome. When implementing a 5-level triage system multiple nurses will triage the same patient at the same level.
1. Do I ever triage a patient based on times for an ER’s arrival to departure requirements?
No. Although many ERs are now tracking arrival to departure times you cannot triage a person based on the length of time for a resource. For instance, if you have a fast track area that sees level 4 patients and your CT department is behind in CTs you would not make your level 4 patient a level 3 to fall into the time requirements.
2. Why is there a significant difference between a 4-level and a 5-level triage system?
Education and training are probably the biggest factor. When the 5-level system was implemented there was training provided to staff members. This included an algorithm to follow. The 4-level system left the decision between levels to be made by each individual nurse.
3. Do you always have to completely follow the ESI algorithm?
No. Although this system works very well there are times that other factors have to be considered, such as, patient age, history, and medications

Daniels, J. H. (2007). Outcomes of Emergency Severity Index Five-Level Triage Implementation. Advanced Emergency Nursing Journal, 29(1), 59. Retrieved from
ESI Triage Research Team. (2014). Emergency Severity Index (ESI): A Triage Tool for Emergency Departments. Retrieved from
Singer, R. F., Infante, A. A., Oppenheimer, C. C., West, C. A., & Siegel, B. (2012, March). The use of and satisfaction with the emergency severity index. Journal of Emergency Nursing, 38(2), 120-126. Retrieved from…...

Similar Documents

Premium Essay

Level 5 Leader

...LA level 5 leader has specific qualities that make them so great. They are stubborn and ruthless but they are humble. Level 5 leaders accomplish great things for their company and never take any credit because they give the credit to their people, luck and external factors. Making their company successful and great is what motivates them. When they leave, they expect their company to be even better. These qualities are what makes a level 5 leader take a good company and turn it into a great company. A transactional leader focuses on structure and process rather than outside the box thinking. Transactional leaders use positive and negative reinforcement to manage employees. Praise and bonuses when employees do well is some positive reinforcements that they use. Reprimands or suspensions when work quality falls or something else goes wrong is some negative reinforcements that they use. Transactional leader are also especially effective in times of crisis. A transformational leader can motivate people to want to change, to improve, and to be led. They do this by being a role model. Transformational leaders motivate people to achieve high standards and challenge people to develop creative solutions. They develop people on individual basis. Transformational leaders are great at aligning the company’s interests with employee needs. Executive A is a level 5 leader. Colleagues describe as driven, fiercely ambitious and entirely focused on the company. He shies away from the......

Words: 566 - Pages: 3

Premium Essay

How Business Use Information System

...Chapter 2 Global E-Business: How Businesses Use Information Systems 2.1 © 2010 by Prentice Hall Management Information Systems Chapter 2 Global E-Business: How Businesses Use Information Systems LEARNING OBJECTIVES • Define and describe business processes and their relationship to information systems. • Evaluate the role played by systems serving the various levels of management in a business and their relationship to each other. • Explain how enterprise applications, collaboration and communication systems, and intranets improve organizational performance. 2.2 © 2010 by Prentice Hall Management Information Systems Chapter 2 Global E-Business: How Businesses Use Information Systems LEARNING OBJECTIVES (Continued) • Explain the difference between e-business, ecommerce, and e-government. • Assess the role of the information systems function in a business. 2.3 © 2010 by Prentice Hall Management Information Systems Chapter 2 Global E-Business: How Businesses Use Information Systems The Tata Nano Makes History Using Digital Manufacturing • Problem: Outdated manufacturing processes, timeconsuming manual labor. • Solutions: Digital manufacturing systems allowed Tata to create a $2,500 car without sacrificing safety or value. • Dassault Systems’ Digital Enterprise Lean Manufacturing Interactive Application drastically reduced development cycle. • Demonstrates IT’s role in fostering innovation and improving efficiency. •......

Words: 2508 - Pages: 11

Premium Essay

How to Use Qtp

...QUICK TEST PROFESSIONAL 11 Table of Contents 1 Session 1 INTRODUCTION TO QTP 9.5 3 1.1 Introduction 3 1.2 Add-ins in 9.5 3 1.3 Use of Addins 3 1.4 Add-in Manager 4 1.5 Benefits of Automated Testing: 4 1.6 The 7 phases of QTP 5 1.6.1 Preparing to record 5 1.6.2 Recording a session on your application 5 1.6.3 Enhancing your test 6 1.6.4 Debugging your test 6 1.6.5 Running your test 6 1.6.6 Analysing the test results 6 1.6.7 Reporting defects 6 1.7 QTP Main Window 7 2 Recording Modes and Run Modes 11 2.1 Major steps before scripting 11 2.2 Exercise 11 2.3 Recording Modes 12 2.3.1 Normal 12 2.3.2 Analog 12 2.3.3 Low Level 14 2.4 Run Modes / Execution Modes / Playback Modes 15 2.4.1 Run Mode 15 2.4.2 Maintenance Run Mode 15 2.4.3 Update Mode 16 3 Session 3 17 3.1 Introduction 17 3.2 Object Repository Types 17 3.2.1 Local Object Repository 17 3.2.2 Shared Object Repository 18 3.2.3 How to associate Shared Repository 19 3.3 Object Repository Window 19 3.4 Exporting Local Objects to an Object Repository 20 3.5 Managing Shared Object Repository Associations: 20 3.6 Object Repository Manager 21 3.6.1 Performing Merge Operations 22 4 Section 4: SYNCHRONISING YOUR TEST 25 4.1 Synchronisation Options 25 4.1.1 Modifying Timeout Values 25 4.1.2 Adding Exist and Wait Statements 25 4.1.3 Creating Synchronisation Points 25 4.2 Exercise 26 4.2.1 Using Wait......

Words: 7929 - Pages: 32

Premium Essay

How to Become a Level 5 Leader

...How to Become a Level 5 Leader - Part 1 by Carl Robinson, Ph.D., copyright 2004 Jim Collins discovered when analyzing the research for his book "Good to Great," that the leaders who ran the "great" companies during the transition from good-to-great were all "Level 5" leaders. For those of you not familiar with "Good to Great," the qualifying criteria was that a company had to have achieved an average cumulative stock return of at least 3 times the market over a 15 year period. Only 11 of the Fortune 500 companies met all the criteria they used. Collins said that the "data won" when it came to understanding the forces behind all good to great companies. In other words, his findings were derived from hard data not from personal opinion or intuitions about what helped propel a company grow from good to great. "...Level 5 leadership is an empirical finding, not an ideological one." "The good-to-great executives were all cut from the same cloth. It didn't matter whether the company was consumer or industrial, in crisis or steady state, offered services or products. It didn't matter when the transition took place or how big the company. All the good-to-great companies had Level 5 leadership at the time of the transition. Furthermore, the absence of Level 5 leadership showed up as a consistent pattern in the comparison companies..." In a nutshell, Level 5 Leaders "blend extreme personal humility with intense professional will." In a previous executive briefing (Charisma Is No......

Words: 2802 - Pages: 12

Free Essay

Global E-Business: How Businesses Use Information Systems

...Management Information Systems 13e KENNETH C. LAUDON AND JANE P. LAUDON CHAPTER 2 CASE 2 GLOBAL E-BUSINESS: HOW BUSINESSES USE INFORMATION SYSTEMS The Emerging Social Enterprise (a) The Comcast Social Enterprise Story; L= 2:50 VIDEO CASE Systems URL; L=2:50. (b) Social Enterprise: Transforming the Firm; L=8:29 VIDEO CASE URL continued Chapter 2, Case 2 salesforCe.Com: the emerging soCial enterprise 2 SUMMARY is the leading provider of enterprise cloud-computing applications with 2011 revenues of $1.6 billion. It provides a comprehensive customer and collaboration relationship management, or CRM, service to businesses of all sizes and industries worldwide and a technology platform for customers and developers to build and run business applications. Recently they have made a number of acquisitions of social technology firms and now offer cloud-based social enterprise services to their primary customers such as Toyota, Gatorade, and Groupon. Salesforce is building private social networks for large corporations and their customers. In addition, is attempting to transform itself into a social enterprise. Comcast (the second largest cable television network operator in the United States) has also begun to use social platforms like Twitter to respond to customers, a first step in the process of becoming a social enterprise. ...

Words: 1184 - Pages: 5

Free Essay

Implications of Big Data for the Design, Implementation and Use of Enterprise-Level Information Systems in Defense

...Implications of Big Data for the design, implementation and use of enterprise-level information systems in Defense While technology rapidly advances and information becomes a strategic asset, Big Data arouses the demand of politicians and military leaders to make use of possible information advantages to allegedly better support the military mission (DOD, 2010). However, the defense sector is still struggling with the implementation of adequate enterprise-level information systems. Therefore, militaries have to assess the necessity of using Big Data within the different business processes, and they have to ensure that the current implementation of enterprise-level information systems remains adaptable and scalable for future business needs. The amount of data is continuously on the rise due to the rapid growth of mobile devices and applications, smart sensors and devices, cloud computing solutions, and […] portals (“Impact,” 2013). Also, the capability to analyze and to correlate structured with unstructured data will enhance. But militaries must avoid getting distracted from implementing a good information management system that serves current business needs, rather than trying to rapidly dominate Big Data. Instead, the success of todays mission has to gain center stage. Thus, one has to focus on three principles. First: One has to act now but also has to keep in mind that there has to be a transition from information management to Big Date in the future, as Big Data will......

Words: 647 - Pages: 3

Premium Essay

Level 5

...Introduction The article, “Level 5 Leadership” written by Jim Collins is regarded as one of the best article published in Harvard Business Review. This classic article has identified Level 5 leadership as key ingredient for transforming a company from merely good to truly great. Besides, the author has also introduced the concept of Level 5 leader for the first time from this article. Level 5 leader is defined as an executive who is able to blend genuine personal humility with intense professional will. Summary The Level 5 leadership is an accidental concept which emerged from the findings of the research undertaken by the author himself. The research, which was carried during 1996-2000, was undertaken with the objective to seek answer to one question “Can a good company become a great company and if so, how?” Intrigued by the scenario why great companies exhibited mediocre performance and what can be done to make mediocre company into the great, 11 companies which showed the shift from good to great was selected from 1435 companies for the research purpose. The result of the research, derived from both the qualitative and quantitative analyses showed Level 5 leaders as catalyst for transforming a good company into a great one. Although the research also identified six additional factors such as getting right people on the bus, Stockdale paradox, buildup-breakthrough flywheel, the hedgehog concept, technology accelerators and a culture of discipline responsible for this......

Words: 1543 - Pages: 7

Premium Essay

How Businesses Use Information Systems

...How Businesses Use Information Systems Objectives: * Identify the features of a business that are important for an information system * Describe the way in which information systems support business operations * Explain how the information systems improve organizational performance * Assess the role of the information system within a business Defining the Features of a Business Four Basic Business Functions * Manufacturing and production – an arrangement of people, machines, and business processes (procedures) that will produce the product * Business Process * Assembling the product * Checking for quality * Producing bills of materials * Sales and marketing – who will attract customers, sell the product and keep track of after sale issues, such as warranties and maintenance * Business Process * Identifying customers * Making customers aware of the product * Selling the product * Finance and accounting – once you generate sales, to keep track of financial transactions, such as orders, invoices, disbursements, and payroll. This group will see out sources of credit and finances. * Business Process * Paying creditors * Creating financial statements * Managing cash accounts * * Human resources – group of people to focus on recruiting, hiring training, and retaining employees * Business Process * Hiring......

Words: 2545 - Pages: 11

Premium Essay

Ilm Level 5 1

...Institute of Leadership and Management Level 5 Assignment 1 Becoming an Effective Leader Institute of Leadership and Management Level 5 Assignment 1 Becoming an Effective Leader AC 1.1 – Evaluate your own ability to use a range of leadership styles, in different situations and with different types of people, to fulfil the leadership role. Having reflected on my own leadership style, I have thought about the way in which as a leader, I have historically led a team. Over the years working within a nursing background I found it difficult to be a specific type of leader due to the thinking that as a nurse you never led, you were a manager that was led. I was far from the truth… I have worked with very different people from all levels of abilities from cleaners through to consultant doctors and have led differently depending on the person I am leading. A scenario I can recall was a time when I instructed a cleaner to decontaminate a side room ready for another patient to occupy. I used a Delegation style approach to the task and 4 hours later, I found the task was not completed due to poor time management by the cleaner. This had a negative consequence of delaying another patient’s admission to the unit until the task was completed and caused conflict between myself and the cleaner as she had not undertaken the task I had set. The positives of this leadership style so I thought, were not to dictate to her what she has to do, but to allow her to lead......

Words: 3542 - Pages: 15

Premium Essay

Hnd Level 5 Pearson

...Course Name: | Edexcel BTEC Level 5 HND Business and Management | Assignment Name: | Managing Financial Resources and Decisions | Section 1: Understanding the Source of Finance Available to Business IDENTIFY THE SOURCES OF FINANCE AVAILABLE TO BUSINESS In order to set up a business the owner or business needs money to get it going, and in cases of established businesses, keep it growing. Business owners will usually use some of their own money coupled with other sources of finance to start their business. There are several ways to acquire financing and a few of them are personal capital and borrowing from friends, borrowing from a bank, factoring, invoice discounting, leasing, hire purchase and franchising. For larger companies they have the advantage of being able to sell shares to raise capital, they can also have large investors, and being able to ‘raise capital’, they can also retain earnings in order to use the money as cash flow for further developments in the company or for a particular project (this money belongs to shareholders). Companies who are already established can retain their profits for a period of time and use this money in the future for projects or business needs, this is usually shareholder dividend and ultimately belongs to the shareholders, but the company is using it to expand or better the business. The selling of company assets is also seen as a way of raising capital, however if you are selling off your assets how does this help your......

Words: 3778 - Pages: 16

Free Essay

How to Use Photoshop

...INTRODUCTION  How to Learn Photoshop A huge advantage of Photoshop is you have more ways to learn it, like this page here, than any other program. So many people know it it's easy to learn just about anywhere. The best way to learn Photoshop is to take a class at your local community college to learn the basics of Lightening Underexposed Images and Correcting Color Casts and White Balance Problems. These basic adjustments are covered in every introductory Photoshop class and book so I'll just cover them quickly below. You must be fluent in these to get anywhere with Photoshop for optimizing images. Photoshop also has built-in help as well as free tutorial usually included in the box. All you need to do is choose how you learn best and go that way. Personally I learn best from an in-person class or having an expert show me in person. When I have a question about how to find some obscure tool or how to make a command work I just choose help from the HELP menu.   Basic Operation and Tricks of the Trade All these adjustments work with every kind of image. That's why skilled photographers feel sorry for people who toil away with RAW files just so they can correct exposure and white balance later. You can do it all to any JPG image in Photoshop without all the hassle. The tricks below presume you have at least a basic navigational familiarity with Photoshop. You can get that from any book or community college class, or even the built-in help! Photoshop has been around......

Words: 4167 - Pages: 17

Premium Essay

Level 5 Irish Legal System

...The Irish Legal System Task 1 There are five different courts in the Irish legal system. They start with the District Court which is the lowest court and has the lowest jurisdiction and work up to the Supreme Court. The District Court has a limited and local jurisdiction. It can deal with claims of up to €15,000. It can hear cases like damages in tort, family law and some license applications. It also has a jurisdiction to sit as a Smalls Claims Court with max ruling being €2,000. The Circuit Court is the next court on the ladder it can hear appeals from The District Court. It can deal with claims up to €75,000. There is only a judge there is no jury in this court accept for cases of defamation. This court deals mostly with contract and tort law cases. The High Court is the next highest court and it hears appeals from The Circuit Court. It has an unlimited jurisdiction and the money that can be claimed is unlimited. It can hear cases in tort law and family law. There are 37 High Court judges. The Court of Appeal hears appeal cases from The High Court. It was established on 28th October 2014 and is placed between The High Court and Supreme Court. It hears cases that would before have been heard by The Supreme Court. When is session there are three judge who hear and decide the case. The Supreme Court is the final appeal in civil cases in Ireland. The court may agree with or reverse any decision made by a lower court or order a new trial. The Supreme Court hears......

Words: 1118 - Pages: 5

Premium Essay

Emergency System Triage

...The word triage derives from a French word Trier; meaning to sort. Triage is a process that assigns a category to individuals from a large group to facilitate sorting and decision making. Through the years, the triage process has been used by the military to return soldiers to the battle field, in mass casualties to rapidly sort and treat large numbers of wounded, and in our medical facilities/Emergency Medical System (EMS) to assign acuity levels and route patients to the most appropriate facility for the appropriate level of care. Literature shows that the use of evidence-based practice to develop screening protocols has greatly improved the outcomes of patients who enter into our medical system either through emergency departments (ED) or by emergency medical services (rescue). The following will discuss two screening protocols that are supported by American Heart Association (AHA) as well as, other renowned institutions and are being implemented nationwide in medical facilities and pre-hospital settings to provide a higher level of care to our patients. The first protocol is a rapid screen for Acute Coronary Syndrome (ACS). American Heart Association and the American College of Cardiology have both published literature in support of the use of an electrocardiogram (EKG) within 10 minutes of arrival for patients who present with acute chest pain in order to rapidly identify acute coronary syndrome. Research shows that obtaining the EKG in 10 minutes greatly improves...

Words: 962 - Pages: 4

Free Essay

Btec Level 3 H&Sc Unit 5 Major Body Systems

...Major body systems Cardio-vascular The cardiovascular system, also called the circulatory system, pumps blood around the body. The right side of the heart pumps deoxygenated blood to the lungs where oxygen diffuses into the blood, it then returns to the heart where it is pumped around the body. It also allows nutrients, hormones, oxygen and carbon dioxide to be transported around the body. Heart: The heart is made up of three layers: * Pericardium – the outer layer of the heart made of two fibrous sacs with fluid between them. It is there to protect the heart and prevent friction between the different beats as well as preventing distension of the heart. * Myocardium – is a specialist cardiac muscle and does not have control over itself. It contains a network of fibres that transmit the hearts electrical signals causing the heart to contract. The myocardium at its thickest at the apex of the heart and it thins towards the base in accordance to the workload that the heart undertakes. There is fibrous tissue running through it providing support as well as the specialist fibres that conduct the electrical signals. * Endocardium – the endocardium is a smooth epithelial tissue that allows a rapid movement of blood, it extends through all the vessels in the circulatory system. The heart is made up of four chambers. The septum divides the two sides of the heart and on each side of the heart there is an atrium – where blood goes into – and a ventricle – where blood......

Words: 6118 - Pages: 25

Free Essay

How to Use

...How to use the niche club preparation folder This folder is divided into 9 main parts: 1. Must Do – This folder contains essential readings that we consider are extremely important for your interviews. 2. Should Do – This folder contains important readings that one should read after finishing the “Must Do” folder. It builds upon the articles on the “Must Do” folder. 3. Can Do – This folder contains articles referring to a variety of topics on marketing. This folder would help you look more knowledgeable in an interview if they quiz you on these topics. 4. Career Guide – The career guide helps you decide why marketing should be your career option. It also talks about the skills required to be a successful marketer. 5. Brand Updates – This folder contains information about different companies and must be done once you get the shortlists from these companies. 6. REMs – This folder contains all the documents used in the Niche placement preparation REMs. 7. Questions asked in summers – This folder contains questions that were asked by different companies in the previous years. We are updating the folder with feedback from as many Tuchhas as possible but it will not contain the entire spectrum of questions and should be used only to identify a trend. 8. Interesting links – This folder contains interesting links that we think are useful for you. We would keep updating the same during the course of your preparation. 9. Newsletters – This folder contains the Niche newsletters and......

Words: 325 - Pages: 2

Unique Notification | Accessori portati | Captulo 490 : Poderosos rivales independientes! El comienzo de la