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Triage is the prioritizing of patients in an emergency situation to determine which ones need medical care most urgently. It can be used in the field to determine priority for first aid and transportation, or in a hospital to prioritize the need for diagnosis and treatment.
In an emergency room, patients are routinely triaged by an admitting nurse who has the authority to make a preliminary diagnosis and refer patients to physicians depending upon their symptoms upon admission. Patients who arrive on life support are moved to the front where even physicians treating serious but non-life threatening conditions may be called in to work on the case. Patients seeking routine care usually have to wait for long periods of time.
In almost every case, a patient will be prioritized if immediate medical attention is likely to result in a positive outcome. Those patients are even moved in front of patients who may have more serious conditions, but are unlikely to live no matter what treatment they receive.
Triage is usually the most important in any event with numerous simultaneous casualties, such as a bus crash or a structural collapse. A natural disaster which lasts for several hours is also likely to make triage more important.
The use of computer software which uses algorithms to prioritize patients is becoming more common. Another common procedure is to use triage tags - a standardized tag that identifies the patient, shows their triage score, and allows the patient to be tracked through the diagnostic and treatment process.
Triage can also be used in the discharge process when medical resources are strained to determine which patients are likely not to suffer an adverse outcome from immediate discharge.
In the United States, the triage system used is usually a four class system, each class characterized by a specific color:
- Green - Minimal - People with minor injuries where first aid is sufficient to release the patient. A good example would be minor non-bleeding lacerations.
- Yellow - Injured/Moderate - People with injuries that need specialized medical treatment, but whose condition will not worsen with time. A good example is a broken bone, which can be left in a splint until x-rays and a cast can be arranged.
- Red - Immediate/Severe - People who require immediate medical attention to survive, such as those with multiple injuries that require surgery, such as a gunshot wound victim.
- Black - Presumed Deceased - A patient with no vital signs. On site, these patients are placed on their side so that in the unlikely event that vital signs returns, they will be able to breathe even if they vomit..