What Is Emergency Room Triage?

Emergency room triage is a process through which emergency room patients are registered, given a preliminarily diagnosis, and ranked in order of treatment priority. The triage system helps emergency room personnel keep track of the different patients waiting for care. It is designed to ensure that life-threatening injuries receive the most prompt treatment, regardless of how many other patients are already waiting.

Traditional queues and first-come, first-served policies work well in a lot of settings, but emergency medicine is not among them. Emergency room doctors see all sorts of injuries, from typical sprains and colds to heart attacks, organ failures, and serious wounds. Requiring patients to wait in line in the order that they arrived for care could create a range of different life-and-death situations. Emergency room triage is one way that ER staff seek to avoid this result.

In many respects, emergency room triage is a prioritization system. A triage nurse usually determines the nature of the patient’s injuries, as well as what kind of care is needed. Different hospitals use different triage systems, but all involve breaking patients into three categories: critical or life-threatening; urgent, but not life-threatening; and non-urgent.

Priority is always given to patients with critical or life-threatening conditions. The emergency room triage system assures that patients in this category are the first ones that doctors see. Once all of the critical patients have been treated, doctors will then turn to patients in the urgent category. Only after all of the urgent cases have been treated will the patients deemed non-urgent be provided with care.

Triage as an emergency room system has widely proved effective as a way of prioritizing care, however inconvenient or unfair it may seem to those waiting. On busy days, emergency room triage is one of the leading causes of long emergency room wait times. A patient who arrives first thing in the morning but is assigned to the non-urgent category may continue getting displaced by more critical patients that come in throughout the day.

Some hospitals, particularly those that are large and well-staffed, may have different divisions for different types of patients. Many emergency rooms have "fast track" options for patients in the non-urgent care category who have only minor injuries, scrapes, or sprains that can be quickly treated by a staff doctor or an ER nurse. If a hospital has a children's or pediatric emergency room, young patients may be referred there, which can reduce their overall wait time.

Emergency room triage, like all facets of emergency medicine, can be unpredictable, and can fail. The triage program works best when most of the people needing care are in the non-urgent category. When a lot of the people are classified as having life-threatening injuries or conditions, it can be hard to decide who among them should be treated first. A lot of the secondary triage decision has to be made very quickly, and often involves at least some guesswork.