In safe hands: explaining triage
Posted on 23 July 2015
The triage process in Mediclinic Emergency Centres speeds up the delivery of time-critical treatment for patients with life-threatening conditions, as it ensures the sickest patients are seen first. It also helps improve patient flow and reduces waiting times. Here’s how it works.
According to Theresa Geldenhuys, unit manager of Mediclinic Cape Gate’s Emergency Centre (EC), triage is vital in the streamlining and prioritising of patient care in the EC. Unlike a doctor’s consultation room where appointments are made and everyone arrives more or less according to their appointment times, the EC can quickly become congested with multiple patients arriving within a few minutes of each other. Triage is used to determine which patient needs care sooner rather than later.
Patients with life-threatening conditions must receive immediate attention, says Dr Theunis Potgieter, head of the EC at Mediclinic Stellenbosch. ‘Triage ensures that we see the most urgent cases first. We see the full spectrum of trauma and acute medical emergencies, and everyone from national and international sportspeople to students, the elderly, members of the surrounding farming community and tourists from all over the world.’
Christell de Lange, unit manager at Mediclinic Sandton’s EC explains the triage process further: ‘Patients are sorted using a scientific triage scale and appropriately prioritised according to measurement of certain signs and the presence of key facts in their history. These signs, symptoms and measurements enable us to assign a patient into one of four groups – red, orange, yellow or green.’
What the triage colours mean
Red = emergency: the patient is in imminent danger of dying or disability and needs to be seen immediately.
Orange = very urgent: the patient is in a serious condition but can wait a few minutes longer.
Yellow = urgent; the patient is very ill but can wait longer – up to 60 minutes.
Green = less urgent/routine: the patient has a minor condition and is rated stable at the time of triage.
‘Triage is mainly done by enrolled or registered nurses, but that depends on each unit’s staff composition and capabilities. Enrolled nurse auxiliaries also require knowledge and training in triage as it may happen that the higher-qualified nurses are not available at that time to perform triage due to circumstances already in play within the EC,’ explains Theresa.
Christell continues: ‘The scientific triage scale is known by all nursing staff in the Sandton EC, but I have specifically made triage the responsibility of the professional nurses. This means I have a professional nurse who is responsible for triaging of walk-in patients and the rest of the staff will assist as necessary.’
Christell currently has seven professional nurses in her unit, of which one is trauma trained and the rest all trauma experienced. This means they have completed fundamentals in emergency nursing, which is a four-month compulsory course. Christell proudly adds that all the Sandton EC professional nurses have successfully completed their certificates in advanced cardiac life support.