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How to triage

02 June 2018
12 mins read
Volume 9 · Issue 5


Triage is the process of organising patients according to the severity of their condition and getting each patient treatment within an appropriate time frame. Good triage should be implemented in every stage of patient care, from the primary phone call to the patient arrival, to ensure each patient receives the care it needs. This article discusses the different triage scoring systems available, communication with the owner over the phone and face to face, and triage of the patient on arrival through assessment of the three major body systems. There is also discussion of the secondary survey to determine the patients that do not have an immediately life-threatening condition, but where there is potential for their condition to worsen rapidly.

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.

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