Understanding the Triage Process in the Emergency Department

In the healthcare system, remote triage ensures that people needing Emergency Room treatment get the proper care at the right time. The remote triage process has also made patient categorization easy, regardless of the patient’s location. Triage nurses assess patients’ conditions over the phone and assign them a category based on their condition.

This is especially helpful for patients who need critical care at workplaces or locations where waiting times are high for specific reasons. This article explores how telephone triage nurses work and why remote triage is essential in emergency care.

What is a Triage Process?

The triage process sorts patients based on how urgent their medical needs are. In a traditional ER setting, patients are assessed based on the severity of their symptoms, allowing the most critical cases to be treated first. 

This assessment happens over the phone in remote triage, and triage nurses follow the Schmitt-Thompson protocols, the gold standard in telephone triage. The protocols include checklists for categorizing patients based on their symptoms, conditions, and medical history and determining the specific care and treatment.

Telephone triage nurses ask detailed questions, listen carefully to the patient’s symptoms, and use their medical knowledge to decide how urgently the patient needs care. This process ensures that people who need help immediately get it, even if they can’t get to the hospital immediately.

Understanding the Red Patient Meaning 

In the triage process, patients are categorized based on the urgency of their medical needs. A red patient labeling indicates that the individual requires immediate medical attention due to a life-threatening condition. 

Criteria for Categorizing a Patient as Red

To categorize a patient as red, healthcare providers typically assess several critical criteria, including:

• Vital Signs: Abnormal vital signs such as extremely high or low blood pressure, rapid heart rate, or altered consciousness.
• Symptoms: Presence of severe symptoms such as difficulty breathing, chest pain, severe bleeding, or unresponsiveness.
• Mechanism of Injury: In trauma cases, the mechanism (e.g., high-impact accidents) may indicate the potential for life-threatening injuries.
• Patient History: Pre-existing conditions that may exacerbate the current situation can also influence the red designation.

Understanding Telephone Triage

Telephone triage, a pillar of modern healthcare delivery, expedites the initial evaluation of patients seeking medical help. 

Emergency rooms in the US are often crowded with patients needing immediate attention and those with less severe conditions that don’t require emergency care. In these situations, telephone triage is crucial in prioritizing who receives treatment first and directing others to appropriate medical resources like x-rays, lab tests, or other non-emergency services.

In a telephone triage process, nurses or doctors assess the patient’s condition over the phone by:

1. Discuss the patient’s symptoms, conditions, and medical history in detail.
2. Reviewing blood test results and x-rays without needing a face-to-face appointment.
3. Guiding the patient to book a doctor’s appointment if necessary. Patients requesting a doctor’s consultation usually receive a call within two hours from the duty doctor, who will determine if the patient needs to visit an emergency clinic, schedule a later appointment, or address the issue in another way (e.g., arranging a blood test, completing a referral, or resolving a prescription query).

For example, a patient experiencing chest pain may be considered high-acuity and instructed to seek immediate emergency care, whereas someone presenting with minor allergic symptoms may be advised to self-care or a scheduled visit. 

How Telephone Triage Nurses Handle Patient Emergencies?

Calling a telephone triage nurse can be for various reasons, like asking about mild symptoms or seeking advice on caring for a sick child. But sometimes, the situation is more serious, like when someone has severe chest pain. In these cases, the nurse must act quickly and know exactly what to do.

• Start by Building Trust: When a patient calls with severe symptoms, the nurse needs to earn their trust quickly. This means listening carefully, being respectful, and avoiding medical jargon. Patients who trust the nurse are more likely to follow the advice.
• Show Empathy While Giving Clear Advice: The nurse should understand the patient’s feelings. It’s important to acknowledge their fears and explain why calling 911 might be necessary. The nurse should explain that emergency services can start treatment immediately if something serious, like a heart attack, happens.
• Stay on the Line Until Help Arrives: If the nurse advises the patient to call 911, they should stay on the phone until the emergency operator takes over. If the patient has to hang up to make the 911 call, the nurse should arrange to call them back in a few minutes to ensure they are okay.
• Keep a Calm and Reassuring Tone: The nurse must remain calm and reassuring throughout the call. This helps keep the patient calm and ensures they feel supported. The nurse should listen to the patient’s concerns and address them honestly.

• Respect the Patient’s Choices: Patients may choose not to follow the nurse’s advice. They might drive to the hospital or wait to see their doctor. If the patient is thinking clearly, the nurse must respect their choice, even if they disagree. However, the nurse should still document that the patient refused the advice.
• Take Time to Process the Call: After handling an emergency call, the nurse must take a few minutes to process what happened. 

Conclusion 

Emergency departments rely heavily on the triage process to ensure patients receive care promptly according to the severity of their conditions. Triage nurses play a pivotal role in this process, and their assessments are crucial for effective patient management. 

Additionally, triage doctors are another option in severe cases where it is essential to decide without delay. A trained physician can reduce the wait time by using a telemedicine platform and providing prompt treatment assistance over the phone. 

Take Extra Measures by Partnering with a Trusted Remote Triage Partner

At WorkPartners, we have experienced professionals to ensure a smooth and hassle-free triage process. Educating your team about triage services and other critical safety protocols empowers them to respond swiftly and effectively in emergencies.

Contact us at (800) 359-5020 to learn more about our comprehensive safety training programs and remote triage solutions to meet your needs.