How to triage

The word ‘triage’ is the French word for ‘to sort’ (Breton, 2011). It became vital during the First World War for injured soldiers to be organised according to severity of injury on the battlefield. Since then it has become vitally important in the emergency room setting to organise the patients that need to be seen immediately from the patients that can wait, by assessing the three major body systems: respiratory, cardiovascular and neurological. Triage in emergency practice occurs over the phone, in the waiting room, and also in hospitalised patients. The aim of triage is to provide a rapid assessment of the patient based on their physical parameters, to guarantee the life threatening signs are identified early, to ensure the best treatment and outcome.

Human hospitals use different triage scoring systems to sort patients according to how rapidly they need to be seen. These are five point scales, the Manchester Triage Scale (MTS) being the most widely used in Europe. Ruys et al (2012) developed a Veterinary Triage List (VTL) (see Table 1) using the MTS, and adjusted the different discriminators, e.g. cardiac pain, to be more applicable to veterinary patients. The triage system was divided by body system: respiratory, circulatory, neurological, obstetrical, gastrointestinal, urogenital and generalised, with different grades of severity requiring different waiting times (Breton, 2011). Their findings were that a standardised triage system, with the use of physical examination, improved patient waiting times when compared with nurse triage using intuition.