Assign an ESI Level
A 62-year-old with CPR in progress.
What is ESI Level 1
A CT scan is considered a resource in the ESI triage system. True or False
What is True
22-month-old, fever, pulling ears, immunizations up to date, history of frequent ear infections. Awoke screaming, pulling at ears, runny nose this week, alert, tired, flushed, falling asleep now, calm in moms arms, cries with exam. Vitals: Temp 102 F HR 128 RR 28 O2 Sat 97% Assign an ESI level
What is ESI Level 5.
More sensitive then BP to assess for signs of circulatory compromise.
What is cap refill.
Normal pediatric cap refill is less than 2 seconds. Adults is 3 seconds. Prolonged cap refill can indicate poor perfusion before BP changes.
Healthy 10-year-old child with poison ivy
What is none. This patient needs an exam and prescription.
A 53-year-old with complaint of abdominal pain and vomiting's, 3-days post gastric bi-pass surgery.
What is ESI Level 2. Patients is high risk of surgical complications.
A consult to OB is a resource.
What is True. Specialty consults like OB count as a resource.
6-year-old with cough. Cough with fever x 2 days, chills, short of breath with exertion, green sputum, sleeping a lot. Vitals: Temp 104.4 F HR 140 RR 30 O2 Sat 91% Assign an ESI triage level
What is ESI Level 2 The clinical picture indicates high probability of tests that equal two or more resources (ESI level 3). Danger zone vital signs exceeded (SpO2 of 91%, RR 30,) making the patient an ESI level 2.
Struck with a hockey puck. Complains of facial pain, reports vision is blurry in right eye.
What is is a Globe injury caused by trauma. Inspect eye for hyphemia (blood collects in the cornea). ESI 1 requires immediate treatment and surgical intervention.
Healthy 52-year-old man ran out of blood pressure medication yesterday; BP 150/92
What is none. This patient needs an exam and prescription.
A 22-year-old who needs a work note.
What is ESI Level 5
Cardiac monitoring is considered a resource in the ESI triage system. True or False
What is False. Monitoring is part of the routine care provided by ED staff.
A 12-year-old with an earache.
What is ESI Level 5.
Sharp unrelieved upper back pain, spreading to the neck, anxious, and complaints of shortness of breath.
What is symptoms of an Aortic Dissection. ESI 1 and immediate placement in resus room.
Healthy 29-year-old female with urinary tract infection, denies vaginal discharge.
What is one. This patient needs an exam, urine, and urine culture, maybe a urine hCG, and prescription. All of these tests count as ONE resource.
"I have been wheezing for a few days, and today I woke up with a fever. My rescue inhaler doesn't seem to be helping," reports a 43-year-old female with a past history of asthma. Vitals: Temp 100.2 F RR 20 HR 90 BP 138/70 SpO2 95% Assign an ESI level.
What is ESI Level 3. This patient has a history of asthma that is not responding to her rescue inhaler. In addition, she has a fever. At a minimun, she will need two resources: hand-held nebulizer treatments and a chest xray.
It is considered an ESI resource if a patient requires a constant observer to prevent a fall. True or False
What is true. A constant observer at the bedside us considered a resource. However, if a patient is ESI level 2 or high risk because they are a danger to themselves or others, it is not necessary to predict the number of resources they will reuire in the ED.
An unresponsive 14-year-old. EMS tells you he and his friends had been "doing shots."
What is ESI Level 1.
Police blood draws can be done if the patient provides consent. True or False?
What is True. Patients who are in their full decision making capacity can consent to a police blood draw.
Patients who don't consent, or are not capable of consenting (intoxicated, psychotic, altered for other reasons) require a warrant signed by a judge.
A 22-year-old male with right lower quadrant abdominal pain since early this morning. +nausea, no appetite
What is at least 2. This patient needs an exam, lab studies, IV fluid, abdominal CT, and perhaps surgical consult.
A 51-year-old presents to triage with redness and swelling of his right hand. He reports being scratched by his cat yesterday. Past medical history of GERD. Vitals: BP 121/71 HR 118 RR 18 Temp 101.8 F SpO2 98% Pain 5/10 Assign an ESI level.
What is Level 3. This patient probably has a cellulitis of the hand and will require labs and IV antibiotics. Starting a saline lock is not a resources, but IV antibiotics are a resource.
A physical exam is considered a resources. True or False
False.
9-year-old male, head trauma. Collided with another player at lacrosse game. Loss of consciousness for "about 5 minutes" witnessed by coach. Now awake with headache and nausea.
What is ESI Level 2. This patient is assigned an ESI level 2 due to the high-risk information provided in the scenario. Vital signs are not necessary, and patient should be immediately taken to treatment area for rapid assessment.
Injuries that do not fit the patient's ability, lack of timely medical treatment, not providing a safe living environment, coercing to participate in sexual activities.
What is child maltreatment. RNS are mandated reporters. See something/say something.
A 45-year-old obese female with left lower leg pain and swelling, started two days ago after driving in a car for 12 hours.
What is at least 2. This patient will need an exam, lab, lower extremity non-invasive vascular studies.