ESI LEVELS
GI BLEED, ETOPIC PREGNANCY, STEMI, SEXUAL ASSAULT ARE EXAMPLES OF ESI LEVEL?
What is LEVEL 2
TRIAGE ASSESSMENT SHOULD TAKE ON AVERAGE 2-5 MINUTES?
What is FACT
"SO,WHAT BROUGHT YOU IN TODAY"
What is CHIEF COMPLANT
"I CAN'T GET INTO A DENTIST AND TOOTH IS KILLING ME" 35-YR HEALTHY MALE. PAIN FOR 24 HOURS. RATES PAIN 10/10, NO REDNESS OR SWELLING NOTED. T98.8, HR 76,R16, B/P 128/75
What is LEVEL 5. NO RESOURCES NEEDED, PHYSICAL EXAM WITH REFERRALS TO DENTIST & RX. NOT A 2 EVEN THOUGH PAIN 10/10. REMEMBER TRIAGE IS SUBJECTIVE & OBJECTIVE. (REFER TO TRIAGE ALOGRITHM)
MOTHER CARRIES CHILD TO GREETER DESK AND ASKS "DO YOU TAKE OF CHILDREN? WHAT IS YOUR RESPONSE?
What is YES, WE TAKE OF CHILDREN. WE TAKE CARE OF ANYONE WHO PRESENTS TO THE ED.
[PROVIDING INSTRUCTIONS ON HOW TO GET TO ETCH DEDUCTS 500 POINTS FROM TEAM SCORE!]
SORE THROAT, UTI, MINOR LACERATIONS ARE EXAMPLES OF ESI LEVEL?
What is LEVEL 4
TRIAGE DECISION SHOULD BE BASED ON SUBJECTIVE DATA ONLY?
What is FALSE TRIAGE DECISION IS BASED ON BOTH OBJECTIVE & SUBJECTIVE DATA. TRIAGE RN ASSESSMENT AS WELL AS PATIENT STATEMENTS & C/O
YOU AND YOUR MOTHER HAVE WHAT PROBLEM AND REQUIRED SURGERY?
What is PATIENT PAST MEDICAL, SURGICAL, AND FAMILY HX
16YR WALKS INTO ED STATES HE HAD 4 WHEELER ACCIDENT. FLYING OVER THE HANDLE BARS. DENIES WEARING A HELMET AND YOU NOTICE AN ABRASION ON HIS FOREHEAD. COMPLAIN OF SOME TINGLING IN RIGHT ARM
What is LEVEL2. HIGH RISK DUE TO MECHANISM OF INJURY, POSSIBLE CERVICAL SPINE INJURY.
ONLY 1 BED OPEN IN ED, 4 PATIENTS IN WAITING ROOM, 3 MORE HAVE CHECKED IN. MID LEVEL PROVIDER WANTS TO USE TRIAGE ROOM TO SEE PATIENTS. AS TRIAGE RN WHAT IS YOUR RESPONSE?
What is SPEAK WITH CHARGE NURSE / SHIFT LEADER ABOUT AVAILABILITY STAFF AND SPACE. USE STANDING ORDERS. CONTINUE TO TRIAGE PATIENTS.
TRAUMA,OVERDOSE, UNRESPONSIVE ARE EXAMPLES OF ESI LEVEL?
What is LEVEL 1
ED NURSING STANDING ORDERS MAY BE INITIATED BY TRIAGE NURSE TO ENSURE A BETTER PATIENT OUTCOME AND FLOW THRU THE ED.
What is FACT STANDING ORDERS MAY INITIATED TO DECREASE PATIENT WAIT TIMES AND FACILITATE FLOW THRU THE ED.
"DO YOU HAVE FEELINGS OF HOPELESSNESS?"
What is ED SAFETY SCREENING [WILL ACCEPT WHAT IS CSSRS AND / OR SUICIDE SCREENING]
19 Y/O FEMALE PATIENT PRESENTS WITH C/O DYSURIA, FREQUENCY X 3DAYS. DENIES ANY ABDOMINAL PAIN. SITTING IN TRIAGE EATING DORITOS AND DRINKING A MOUNTAIN DEW. VITAL SIGNS WNL PAIN 5/10
What is LEVEL 4. REQUIRE UA
PATIENT PRESENTS WITH CP WITH HX OF AFIB WHAT SHOULD BE IN YOUR TRIAGE NOTE [to paint the picture of why the patient is there]
What is CURRENT PAIN LEVEL, WHEN PAIN STARTED, WHAT WAS PATIENT DOING WHEN PAIN STARTED, ANYTHING MAKE IT BETTER OR WORSE, QUAILITY OF THE PAIN, LOCATION AND RADIATION OF PAIN, CURRENT CARDIAC RHYTHM & RATE, SKIN COLOR / CIRCULATION, CURRENT ANTIARYTHYMIC MEDICATIONS OR ANTICOAGULANT MEDICATIONS.
[PQRST]
PATIENT WITH LICE, MED REFILL, EARACHE ARE EXAMPLES OF ESI LEVEL?
What is LEVEL 5
ACCURACY OF TRIAGE DECISIONS ARE A MAJOR INFLUENCE ON PATIENT OUTCOMES.
What is FACT TAKING TOO LONG TO TRIAGE AND DELAYING TREATMENT PRODUCE POOR OUTCOMES.
THIS HAS TO BE ENTERED BEFORE ANY MEDICATION ORDERS.
What is HEIGHT & WEIGHT [WILL ALSO ACCEPT ALLERGIES]
60YR MALE FOUND ON BATHROOM FLOOR BY WIFE THIS MORNING. CPR IN PROGRESS UPON ARRIVAL TO ED PER ACLS PROTOCOL.
What is LEVEL 1
SUICIDAL PATIENT CHECKS IN. ALL ED ROOMS ARE FULL. WHAT DO YOU DO WITH THE PATIENT AFTER TRIAGE
What is NOTIFY SHIFT LEADER / CHARGE NURSE. DONT LEAVE PATIENT ALONE.
WHO CAN CHANGE ESI LEVELS?
NO ONE except if entered in error. RN documents change in patient condition as applicable and communicates findings to Provider.
ONCE THE TRIAGE RN IS COMPLETED WITH TRIAGE THEIR RESPONSIBILITY ENDS.
What is FICTION! THE TRIAGE NURSE RESPONSIBILITY IS ONGOING! IF THERE ARE NO AVAILABLE ROOMS IN THE ED, THE PATIENT REMAINS IN WAITING ROOM AND THE TRIAGE RN IS RESPONSIBLE FOR THE PATIENT.
DOESN'T HAVE TO BE DONE BY TRIAGE RN BUT MIGHT BE STARTED IF PERTINENT TO CHIEF COMPLAINT
What is OBTAIN "GOOD FAITH" HOME MEDICATION LIST.
50YR FEMALE FELL DOWN BASEMENT STEPS. C/O PAIN LFT SHOULDER. NOTED DEFORMITY TO LFT SHOULDER. PAIN 10/10. CAPILLARY REFILL BRISK, RADIAL PULSE PALP. ABLE TO WIGGLE FINGERS
What is LEVEL 3 PATIENT WILL REQUIRE XRAY, PAIN MEDS, POSSIBLE SHOULDER REDUCTION
EVERY PATIENT REQUIRES A MEDICAL SCREENING EXAM TO DETERMINE IF THEY HAVE AN EMERGENCY MEDICAL CONDITION. IF EMERGENCY MEDICAL CONDITION IS FOUND - PATIENT IS STABILIZED. DO NOT DELAY THE MEDICAL SCREENING EXAM TO OBTAIN INSURANCE INFORMATION.
What is EMTALA