Understanding the Triage Process in Our Emergency Department - UPMC Western Maryland (2024)

When patients report to the Emergency Department of UPMC Western Maryland, our staff uses a method called triage to determine who needs to be seen first. What this means is that we evaluate the severity of patient symptoms rather than take patients back to a room in the Emergency Department based on the order they checked in.

We understand this can feel frustrating for those who have waited a long time for care. However, it is standard practice in hospitals across the country because it is the most efficient way of treating people. It’s also important to understand that we only use the triage system when the demand for emergency services is greater than the staff we have on hand to treat everyone. If you walk in and no one else is waiting, you will receive prompt treatment regardless of the severity of your injury or illness.

What Does the Word Triage Mean?

The word triage originated in the French language and means to select or sort. The French trace the meaning and use of the word back to the days of Napoleon when it was necessary for medical workers to determine who to see first in cases of mass injuries among wounded soldiers. The system has developed over the years to include several levels of determining priority to ensure that all patients receive the best possible service.

Emergency Department Patients Will First See a Triage Nurse

If you arrive at the UPMC Western Maryland Emergency Department by any method other than an ambulance, you will check in with a registrar and then take a seat in the waiting room. A triage nurse will call your name shortly, but this doesn’t mean that you’re going back for treatment just yet. It’s the job of the triage nurse to evaluate each patient to determine the severity of his or her symptoms. This will typically include the following:

  • Ask you several questions about your illness or injury, including your most troubling symptoms and when they started.
  • Take your vital signs such as temperature, blood pressure, pulse rate, and respiratory rate.
  • Communicate with patients and other medical personnel regarding symptoms as well as provide updates to any family or friends who came with you.

The job of a triage nurse is not an easy one. He or she must be able to make quick decisions, often times with little information to base them on. We expect our triage nurses to use excellent communication skills with all parties and effectively handle the stress of multitasking that comes with the job. A triage nurse must have a college degree, pass a state licensing exam, and have certification in several emergency-related areas such as cardiopulmonary resuscitation (CPR).

Telephone Triage

Some patients prefer to call UPMC Western Maryland before making a trip to our Emergency Department. They may not feel certain if they’re experiencing a true emergency, have issues with transportation, or have another reason for calling instead of presenting in person. A telephone triage nurse has a different role from a regular triage nurse because he or she only speaks with people on the phone and doesn’t have the benefit of viewing the symptoms caused by the illness or injury.

If you speak to a telephone triage nurse, he or she will help you decide if you need to come in for immediate treatment. The person in this position may also be able to help you find other resources that would not require you to visit our Emergency Department. This role is essential because it helps to reduce wait times for people who have already presented for services.

The Triage System in Action

While most hospitals follow a similar process for evaluating clients, each has a unique system for assigning a color, numeric, or other type of code to patients depending on the level of severity. The categories below are the most typical assessments that we use when triaging patients here at UPMC Western Maryland.

  • White: No illness or injury detected.
  • Green: Injury or illness detected but symptoms are less serious and not life-threatening. The patient will require help eventually but can wait for others with more serious needs to receive treatment first. Additionally, patients in this category may have waited several hours to report to the hospital after the original onset of symptoms.
  • Yellow: These patients have serious injuries or have presented with several symptoms of a significant illness. They need immediate attention and may sometimes go back for treatment before people with even greater injuries or illnesses because their chance of recovery is higher.
  • Red: Patients at this level have a life-threatening injury or medical attention. They require immediate transport to a hospital room for medical intervention.
  • Black: The patient has already died or has a mortal injury that will cause death. Because there is little that medical staff can do to intervene, patients in the red or yellow categories will typically take priority.

UPMC Western Maryland Emergency Department Contact Information

If you have general questions or wish to speak to a telephone triage nurse, please call 240-964-8500. You can also call our Patient Experience department at 240-964-8104 if you have any concerns about past care you have received at the UPMC Western Maryland Emergency Department.

Understanding the Triage Process in Our Emergency Department - UPMC Western Maryland (2024)

FAQs

What is the triage process in the emergency department? ›

Triage of patients involves looking for signs of serious illness or injury. These emergency signs are connected to the Airway - Breathing - Circulation/Consciousness - Dehydration and are easily remembered as ABCD.

What are the top 5 triage priorities that take precedence in any emergency? ›

The triage registered nurse might assign you a priority level based on your medical history and current condition according to the following scale: Level 1 – Resuscitation (immediate life-saving intervention); Level 2 – Emergency; Level 3 – Urgent; Level 4 – Semi-urgent; Level 5 – Non-urgent.

What are the 5 levels of triage? ›

In general, the triage system has five levels:
  • Level 1 – Immediate: life threatening.
  • Level 2 – Emergency: could become life threatening.
  • Level 3 – Urgent: not life threatening.
  • Level 4 – Semi-urgent: not life threatening.
  • Level 5 – Non-urgent: needs treatment when time permits.

What is the triage status of emergency department visits? ›

If the patient requires two or more hospital resources, the patient is triaged as a level 3. If the patient needs one hospital resource, the patient would be labeled a 4. If the patient does not need any hospital resources, the patient would be labeled a 5.

What are the steps of the triage process? ›

  1. Triage. -identifies and categorizes patients so that the most critical are treated first. ...
  2. Triage Procedure STEP ONE. -Open airway. ...
  3. Triage Procedure STEP TWO. -Check circulation/bleeding. ...
  4. Triage Procedure STEP THREE. ...
  5. If victim passes all tests. ...
  6. Interventions for Immediate. ...
  7. Emergency Severity Index (ESI) ...
  8. ESI-1 1675.

What is an example of emergency triage? ›

There are 5 Triage Levels.

Level 2- EMERGENT, for example, someone involved in a major accident with severe life threatening injuries. Level 3- URGENT, for example, someone with pneumonia and difficulty breathing. Leve l 4-LESS URGENT, for example, someone with an earache or a minor cut requiring stitches.

Who gets seen first at ER? ›

The ER cares for the sickest and most severely injured people first. If the nurse asks you to wait, let the nurse know if your symptoms or condition get worse. Once you are seen by the ER doctor, they may need to run more tests to determine your needs.

What are triage questions? ›

Initial triage questions are designed to ascertain symptoms and their severity. Once a temporary diagnosis for assessment purposes only is found, the Schmitt-Thompson protocols are in place to help triage nurses and callers know how they should proceed.

Who gets priority in triage? ›

People with life-threatening injuries are prioritized over people with minor injuries. The type of triage system a hospital uses will be different from the system used by emergency medical technicians or in disaster situations. Technological advances are changing how triage works.

What is priority 1 patient? ›

PRIORITY 1: Emergency call which requires immediate response and there is reason to believe that an immediate threat to life exists. PRIORITY 2: Emergency call which requires immediate response and there exists an immediate and substantial risk of major property loss or damage.

What do you say to get seen faster in an emergency room? ›

Clear Communication
  • Be specific: Describe your symptoms in detail. ...
  • Use descriptive language: Paint a vivid picture of your symptoms. ...
  • Mention any relevant medical history: If you have any pre-existing conditions or allergies, make sure to inform the medical staff.

How do emergency rooms prioritize patients? ›

Patients are seen based on a “triage system” – that is, the severity of the patient's condition. Every new patient is given an initial medical evaluation. Patients with a critical illness or injury are seen first.

What is the difference between triage and ER? ›

The title triage nurse refers to the type of work a nurse does, whereas an emergency room (ER) nurse refers to the location/specialty a nurse is working in. For example, a triage nurse can implement triage skills in an emergency room, doctor's office, or call center.

What is the difference between emergency room and triage? ›

The term refers to the sorting of sick or injured patients according to their need for emergency medical attention. Triage is thus the method hospital emergency departments use to determine who gets care first.

What happens if you leave the ER after triage? ›

Leave against medical advice (LAMA) patients leave either during the diagnostic or treatment period. Both situations tend to occur when patients experience frustratingly long waits in the ED/ER. Patients who leave without being seen or against medical advice can face a much higher risk of poor outcomes.

What are the 4 categories of triage? ›

The 4 conventional triage categories are:
  • Minor: Green Triage Tag Color. Victim with relatively minor injuries. ...
  • Delayed: Yellow Triage Tag Color. Victim's transport can be delayed. ...
  • Immediate: Red Triage Tag Color. Victim can be helped by immediate intervention and transport. ...
  • Expectant: Black Triage Tag Color.

How does the ER decide who goes first? ›

In triage, the patients with the more urgent medical conditions are seen first. This means that a patient having a heart attack will be seen sooner than someone with a sprained ankle, regardless of arrival time.

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