Emergency departments: what triage means
It’s different from any other line you’ve ever been in. The Emergency Room in the hospital does not operate on a first-come, first-served basis; it operates on the triage system.
Triaging patients means prioritizing a person based on the urgency of their need for care. After registration, triage is the first thing that happens when you seek care at an emergency room.
“Saskatchewan’s emergency rooms use the Canadian Triage and Acuity Scale,” explained Dr. James Stempien, an emergency physician in Saskatoon and the provincial head of emergency care for the Saskatchewan Health Authority.
The Canadian Triage and Acuity Scale (CTAS) ranges from one to five, with one signifying the sickest patients and five the least sick. The triage nurses do their best to do this as accurately and quickly as possible with the information the patients and family give them. The triage levels are not shared with patients as they can change.
Anyone designated as CTAS 1 – needing resuscitation – doesn’t wait to be seen. These patients usually arrive by ambulance and go straight into a treatment area. These are the people who have been in a trauma, have critical vitals signs or may be in cardiac arrest.
“It is someone in imminent danger,” Stempien said.
Those designated as CTAS 2 need emergency care but can wait a short time for treatment. This could be someone with chest pain, or pain from a broken bone. CTAS 3 patients are the most varied, ranging from someone having some difficulty breathing to someone with abdominal pain.
CTAS 4 patients are those who have less urgent issues – mild shortness of breath, minor belly pain, minor cuts that need stitches. These are the people who are stable, and not in too much pain.
CTAS 5 patients are those who are not urgent – those with sprained ankles or a rash, or who need a prescription renewal. These are the non-critical patients.
There are many factors that move patients up or down the triage scale – age, pain, vital signs, medical history, etc.
Someone who may die soon without care cannot wait so they will always been seen first before someone with a sprained ankle for example. That’s why we triage,” Stempien said. “The whole point of triage is not to make people wait for care, but to see the people who need to be seen first."
A patient’s triage status can change while they wait; this is why staff keep an eye on those in the waiting areas, and why patients are asked to report changes in their condition to those staff members.
