Triage in the veterinary emergency room: part 1
Abstract
The triage examination is a rapid assessment of patients presented to the emergency room. The primary survey assesses the respiratory, cardiovascular, neurologic, and urogenital systems in patients to identify life-threatening conditions requiring immediate veterinary attention. Observation of respiratory pattern and rate while listening for respiratory noise can indicate and localize diseases of the respiratory system. The cardiovascular system is assessed by observation of mucous membrane colour and capillary refill time, combined with palpation of peripheral pulses. Neurologic and urogenital triage will be covered in part 2 of this series. Combined with a capsule history, the triage examination is used to identify and stratify emergency room patients so that the patients most in need are assessed and treated first.
The goal of triage is to identify patients with life-threatening conditions who require immediate attention from a veterinarian, and distinguish them from patients that are not as ill (Aldrich, 2005; Drobatz, 2010). Triage is the systematic evaluation and categorization of patients, and is derived from the French word trier, ‘to sort’. Human triage models use levels or codes that are assigned to each patient, and which differentiate those patients who require immediate care from those who can wait for medical intervention.
A triage examination should be completed in less than 2 minutes. Calm, clear, and controlled communication with the owner is essential, and questions should be brief and relevant; a more in depth history will be obtained at a later time (Aldrich, 2005). It is important to drive the discussion in a compassionate tone while remaining confident, to assure the owners that their pet is in good hands — yours. The person performing the triage examination must stay focused on the patient and owner regardless of the activity in the rest of the emergency waiting room (Bateman, 2007).
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