THE TRIAGE PROCESS WHAT YOU NEED TO KNOW

WHAT IS TRIAGE? WHAT DOES MY TRIAGE COLOUR MEAN?

Triage is a process of assigning priority to patients in Emergency Units, based on measurement of certain signs in the patient and the presence of key facts in the history. A Triage nurse will see you and go through a short examination with you this is the triage process, and at the end of this your symptoms and measurements will assign you into one of FOUR groups. These four groups are Red, Orange, Yellow and Green. More detail on these groups is provided below.
WHY AM I BEING TRIAGED?

We have had many problems before where patients have arrived at the Unit very sick, but nobody has noticed this because they were waiting in the queue to be seen in their turn. This can make patients much sicker by the time the doctor sees them: rarely, patients have died as a result. Triage avoids this: by making an assessment of everyone arriving in the Unit and assigning a priority to them, the sickest patients get to be seen first, as is right.
WHY ARE PEOPLE WHO ARRIVED AFTER ME BEING SEEN BEFORE ME?

Unfortunately, when sick patients arrive and they are identified by the triage process, it means that those who are less sick have to wait a bit longer to be seen. Remember, it is your symptoms and measurements (heart rate, blood pressure and so on) that have made you the triage priority that you are. Other patients may be seen before you as they are much sicker. Red patients are those who need to be seen immediately, otherwise they may die. Orange patients can wait a few minutes longer, but are also very sick. Yellow patients are those who are ill but can wait a bit longer say up to 2 or 4 hours. Green patients are those with minor problems. Often these need to be seen in the Emergency Unit, but some may be better seen in a clinic or by a Family Doctor.
WHEN WILL I BE SEEN?

A doctor will see you as soon as possible. If you are waiting, it is because the staff are busy with sicker patients: we ask you please to understand this and be patient. Not all patients need to see doctors. In some centres, we are trying to introduce new means of seeing those patients who have been triaged Green. This may mean that you are seen at triage by a doctor and sent for simple tests. In other places this may involve being seen by a nurse practitioner.
WHAT TO DO IF YOU ARE UNHAPPY

Speak to the staff at the Unit if you feel that you have been triaged wrong or you are unhappy with how long you need to wait. Remember though that triage is a scientifically tested process and is likely to have assigned the correct colour to you. Also remember that the more patients the staff have to speak with in the waiting room, the longer it will take them to treat patients. If you are still not happy, you can write to the Facility Manager / Medical Superintendent with your complaint. The staff will be able to provide you with details. THE SOUTH AFRICAN TRIAGE GROUP, 2009

"Triage" is a French word meaning to sort or to categorize. It is the process of separating people who are sick or injured and giving them treatment based on the severity of their injuries or sickness, their potential for survival and the available resources like medication or bed spaces. The injured are either triaged for on the spot treatment or for transportation to a facility where they can receive more comprehensive care.

History of Triage
Triage came into existence largely due to the need to prioritize care for injured soldiers at war fronts. During the Napoleonic wars that lasted from 1792 to 1815, the French chief surgeon Dominique-Jean Larrey instituted a process to prioritize care for injured soldiers. He believed it was important to provide care to the most dangerously wounded first. He is often credited with the establishment of the triage system. He refined his system of triage over 18 years and 60 battles.

Types of Triage
There are two basic types of triage--the military and civilian triage. Civilian triage gives priority to the persons who have life threatening injuries even if they will take up a lot of resources, while military triage gives priority to persons who can survive with the smallest amount of resources available. People who need large amounts of resources are not treated under military triage.

Read more at Suite101: About Triage: Definition, Types and Process of Triage | Suite101.com http://suite101.com/article/about-triage-a203749#ixzz23SvkXkvC Civilian triage is further divided into hospital triage and disaster triage. Disaster triage is similar to military triage in that the two systems strive to save as many lives as possible with the limited resources at hand.

Disaster Site Triage

At a disaster site, disaster triage systems are used to prioritize treatments or transportation to medical facilities. Various disaster triage systems exist but the popular ones are the START system for adults, the JumpSTART system for children and the START/SAVE system. The START/SAVE method is used when the injured cannot be transported from the disaster site to a source of better medical care. SAVE stands for secondary assessment of victim endpoint. All of these systems use the basic disaster triage process which involves separating the injured into those that need critical, urgent or delayed care and those that are dead or expected to die.

Triage Process
The SMART triage system uses colored tags. The tag colors are red, yellow, green and black. The person who is labeled with a red tag is critical and is given immediate treatment or provided with quick transportation to a hospital if needed. The person who gets the yellow band is treated

or transported after the people with red bands have been taken care of. This person is considered urgent and should have serious injuries that can wait two hours for treatment before becoming life threatening. The person who gets the green band is labeled as delayed and has minimal injuries that can wait over two hours for treatment. The person who gets the black band is dead or expected to die. They are labeled as expectant and receive no treatment. After transportation triage, the injured are matched with and transported directly to facilities that have the capability to treat their injuries.

Hospital Triage
In the hospital, triage involves prioritizing patient care based on the symptoms that they present . The triage nurse uses the ABCs of nursing, skin color, moisture, temperature, pulse, respiration, level of consciousness and visual inspection for deep wounds, gross deformities and bruising to prioritize care that is given to patients in the emergency room. ABC stands for airway, breathing and circulation. She gives first priority to patients whose airways, breathing or circulation are compromised. These patients may have difficulty breathing or chest pain due to heart problems and they receive treatment first. Patients who have extremely life threatening problems are given immediate treatment even if they are expected to die or need a lot of medical resources.

Effects Of Triage
Disaster triage systems used all over the world are similar based on how treatment or transportation is prioritized and the goal is to increase the number of survivors involved in a disaster. Despite this fact, very little research has been done to evaluate the effectiveness of this system. As of 2005, no clinical or scientific research has been done on the the START and JumpSTART triage tools to validate their efficacy in increasing the number of survivors in a disaster area.

Read more at Suite101: About Triage: Definition, Types and Process of Triage | Suite101.com http://suite101.com/article/about-triage-a203749#ixzz23SvyPUjQ