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Correspondence Address:
Awais Shuja
FRCS (Ed), FCPS
Assistant Professor of Surgery
Independent Medical College,
Faisalabad.
Article Citation: Shuja A, Triage systems for trauma care. Indep Rev July-Sep 2014;16(7-9): 244-249.
Key Concepts
Definition of triage
Principles of triage
Triage scales
Outcomes of triage
trauma triage
Abstract
Triage is the process of determination of the priority of patients treatments based on the severity of their condition.
The purpose of the triage is to ensure that the patient recieves the level and appropriate to clinical need and that recources are most usefully applied. Different triage scales have been developed to help health professionals to classify
patients consistently function of emergency around the world.
Key words: Triage Ipswish triage scale Austration triage scale, Triage severe.
Triage is the process of determining the priority of patients treatments based on the
severity of their condition. This distributes
patient treatment efficiently when resources
are insufficient for all to be treated immediately. The term comes from the French verb
trier, meaning to separate, sift or select. Triage may result in determining the order and
priority of emergency treatment, the order
and priority of emergency transport, or the
transport destination for the patient.
Triage may also be used for patients arriving
at the emergency department, or telephoning medical advice systems, among others.
inique Jean Larrey. The term was used further during World War I by French doctors
treating the battlefield wounded at the aid
stations behind the front. Those responsible
for the removal of the wounded from a battlefield or their care afterwards would divide
the victims into three categories:
Those who are likely to live, regardless of
what care they receive;
Those who are likely to die, regardless of
what care they receive;
Those for whom immediate care might make
a positive difference in outcome.
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Definition
Triage is the process of categorizing emergency patients according to their need for
medical care, irrespective of their order of
arrival or other factors including sex, age,
socioeconomic status, insurance status, nationality, race, ethnicity or religion. Triage
is a mechanism that is essential for effective
management of modern emergency services.
Principles of triage
The principal purpose of triage is to ensure
that the patient receives the level and quality
of care appropriate to clinical need and that
resources are most usefully applied. Clinical
justice, including clinical efficiency, aims to
ensure that patient receives appropriate and
timely care.
The concept of urgency is central to triage in
trauma care. Urgency incorporates concepts
of timeliness and is different from severity.
Urgent conditions may not necessarily be urgent, while severe illness may not necessarily
be urgent. Both clinical and environmental
factors contribute to the urgency of any particular patient.
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Category
Description
Performance standard
ATS 3
30 min
75%
ATS 1
ATS 2
ATS 4
ATS 5
Category
Immediate
100%
10 min
80%
60 min
70%
120 min
Description
Resuscitation
Immediate
Emergency
< 15 min
Urgent
< 30 min
Less urgent
< 1 hour
Non urgent
The Australian triage system is the most common and universal system, which is a direct
triage mechanism and has a 5- level categorical scale.
Canadian triage and acuity scale was derived
from ATS. It is a 5 categorical scale .
70%
< 2 hours
Correct triage is associated with positive outcome. Outcomes associated with over or under triage result in inappropriate allocation
of emergency resources, prolonged waiting
times of dangerous complications or prolonging suffering.
Trauma triage
Trauma triage is the use of trauma assessment
for prioritising of patients for treatment or
transport according to their severity of injury.
Primary triage is carried out at the scene of an
accident and secondary triage at the casualty
clearing station at the site of a major incident.
Triage is repeated prior to transport away
from the scene and again at the receiving hospital.
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246
The primary survey aims to identify and immediately treat life-threatening injuries and
is based on the ABCDE resuscitation system.
This includes:
Airway control with stabilisation of the
cervical spine.
B reathing.
C irculation (including the control of external haemorrhage)
D isability or neurological status.
E xposure or undressing of the patient
Red
T1
Immediate priority
Blue
T4
Expectant priority
yellow
Green
T2
T3
Urgent priority
Delayed priority
Treatment at an early stage would divert resources from potentially beneficial causalities, with no significant chance of a
successful outcome
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References
1.
2.
Value
Score
6-9
10-29
>29
1-5
>90
76-89
50-75
1-49
13-15
9-12
6-8
4-5
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3. Lee TJ et al. Does telephone triage delay significant medical treatment? Advice nurse service vs
on-call pediatricians. Archivesof pediatrics & adolescent medicine, 2003, 157:63541.
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