How A Child Is Triaged At The Emergency Department

Have you ever wondered how we as healthcare professionals determine who is seen first when you present to an Emergency Department? 

Have you sat in an Emergency Department wait room and not understood why some people are seen before you, when you have been there longer?

Let us explain the system all Australian hospital Emergency Departments use to determine patient urgency, the Triage system, so that it all makes a bit more sense. 


We know that it is going to be hard as parents and caregivers, waiting in an Emergency Department with a sick child, however it is important to trust in the triage system and know that we as medical professionals are doing our best to prioritise those who need urgent care. 

When you arrive to an Emergency Department you will in most cases firstly see an administration clerk to provide patient details, and following this will be triaged. 

Triage means to pick, to choose, or to sort. 

A triage assessment is undertaken by an experienced, senior nurse and will generally take a couple of minutes. A patient will be assigned a category number referring to their clinical urgency.

As the triage assessment is a relatively quick process, it is important to be guided by the questions the triage nurse is asking and answer as concisely as possible to allow for appropriate care as quickly as possible, for all patients. Don’t worry, a comprehensive history and assessment will be collected by a different member of the emergency department team. 

The Australasian Triage System (ATS) is the clinical tool used to establish the maximum waiting time for medical assessment and treatment of a patient in an Emergency Department. There are five categories as shown below. It is important to note that these categories do not take into account severity, complexity, quality of care, workload or staffing, which can naturally all impact the running of an Emergency Department and subsequently, wait times.

Australian Triage Scale Category Treatment Acuity (Maximum waiting time for medical assessment and treatment) Example of clinical presentation
Category 1 Immediate 

- Cardiac arrest
- Actively having a seizure 

Category 2 10 minutes 

- Severe respiratory distress (asthma attack, croup with a stridor)
- Chest Pain

Category 3 30 minutes  - Broken Bone needing strong pain relief
- Persistent vomiting with signs of dehydration
Category 4 60 minutes  - Head injury with no loss of consciousness
- Sprained ankle  
Category 5 120 minutes  - Chronic constipation 
- Wound not requiring stitches

 

As health professionals, we always strive to meet these treatment times, however the reality is that during busy times, wait times are often longer and you will be seen as soon as possible. 

We understand that to present to an Emergency Department means you have significant stress and worry about your child.  We often explain to parents that if you are waiting in Emergency, it can be seen as a good thing as you have been deemed safe to wait, as opposed to the patients we are rushing through for urgent care.

We are also well aware that change whilst you are waiting to be seen, and it is always imperative to approach a member of the team if your child’s condition is changing or if you are concerned.

If you have some time at home before heading into Emergency, it can be a good idea to be prepared for potential wait times - check out our blog on what to throw in a bag to head to the Emergency Department.

As always, information on this website is for educational purposes only. Please consult your GP for information specific to your child.

References:
*https://acem.org.au/Content-Sources/Advancing-Emergency-Medicine/Better-Outcomes-for-Patients/Triage


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