Emergency department triage

Emergency departments (EDs) have to manage fluctuating numbers of patients with a wide range of illnesses or injuries of differing degrees of seriousness.

The assessment of patients on arrival to decide how urgent their illness or injury is and how soon treatment is required is called triaging. Triaging aims to ensure that those patients assessed as having the most urgent need are treated more quickly than those patients with a less urgent need.

New Zealand EDs use the Australasian triage scale which has five triage categories; triage category 1 patients are very urgent, while triage category 5 patients are less urgent. For each triage category there is a specified maximum clinically appropriate time within which medical assessment and treatment should commence.

However, because of fluctuations in patient numbers, the seriousness of their conditions, and other pressures on hospital resources, these times cannot always be met. In acknowledgement of this, benchmarks are set that indicate the acceptable percentage of patients who will start treatment within the allocated triage time.

The Australasian Triage Scale
Triage Category Description Maximum Clinically Appropriate Triage Time Performance Benchmark
1 Immediately life-threatening, Immediate simultaneous triage and treatment 100%
2 Imminently life-threatening, or important time-critical 10 minutes 80%
3 Potentially life-threatening, potential adverse outcomes from delay > 30 min, or severe discomfort or distress 30 minutes 75%
4 Potentially serious, or potential adverse outcomes from delay > 60 min, or significant complexity or severity, or discomfort or distress 60 minutes 70%
5 Less urgent, or dealing with administrative issues only 120 minutes 70%
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