Introduction

Question 1

Approach to the Emergency Patient

Answer 1

Pressures of time and volume
Variety of conditions faced
Paucity of information available
Limitation of therapeutic options
Constraints of disposition

Question 2

Pressures of Time and Volume

Answer 2

Turbulent flow
Treat first, ask questions later
May have 15 minutes total with each patient
Be aware of priorities among patients

Question 3

Variety of Conditions

Answer 3

Be ready to shift domains rapidly

Question 4

Paucity of Information

Answer 4

Old records unavailable
Poor historians or unable to speak and family unavailable
Information gathering limited

Question 5

Limited Therapeutic Options

Answer 5

Provide symptomatic treatment
Tolerance for mistakes is very low
“Treat and street”

Question 6

Constraints of Disposition Components

Answer 6

Sick or not?
Treat or not?
Admit or discharge?

Question 7

Bedside Evaluation

Answer 7

Build working relationship with patient
Get on patient's level
Think aloud
Listen to your patient, don't interrupt
Watch out for the helpful family member

Question 8

3 Options of Patient Disposition

Answer 8

Admit
Discharge
Transfer

Question 9

3 Common Pitfalls to the Approach of the Emergency Patient

Answer 9

Tunnel vision
Inability to see “forest for the individual trees”
Failure to attend to the patient

Question 10

Define Triage

Answer 10

To sort or choose

Question 11

Define Disaster Triage

Answer 11

Where casualties overwhelm the ability to provide care

Question 12

Routine ED Triage

Answer 12

Goal is to sort according to priorities of medical need

Question 13

4 Categories in Disaster Triage

Answer 13

Immediate
Delayed
Minimal
Expectant

Question 14

Describe the Immediate Category in Disaster Triage

Answer 14

Life threat that is easily addressed

Question 15

Describe the Delayed Category in Disaster Triage

Answer 15

Patient can wait without risk

Question 16

Describe the Minimal Category in Disaster Triage

Answer 16

Patient requires little intervention

Question 17

Describe the Expectant Category in Disaster Triage

Answer 17

Patient will likely die with or without any interventions

Question 18

Goals of Routine ED Triage

Answer 18

Define and classify urgency based on complaint and presentation
Ensure patient safety
Facilitate care and flow through ED
Satisfy legal requirements for “screening”

Question 19

5 Levels of Routine ED Triage

Answer 19

Immediate
Very urgent
Urgent
Semi-urgent
Non-urgent

Question 20

Describe Immediate or Level 1 of ED Triage

Answer 20

Complaint or condition requires immediate assessment and intervention
ANY delay represents unacceptable risk

Question 21

Examples of Immediate or Level 1 Status

Answer 21

Cardiac arrest
Anaphylaxis
Compromised airway

Question 22

Describe Very Urgent or Level 2 Status of ED Triage

Answer 22

Complaint or condition require assessment and intervention within 10 minutes

Question 23

Examples of Very Urgent or Level 2 Status

Answer 23

Chest pain
CVA
Significant bleeding
Major trauma

Question 24

Describe Urgent or Level 3 Status in ED Triage

Answer 24

Complaint or condition require assessment and intervention within 30-60 minutes

Question 25

Examples of Urgent or Level 3 Status

Answer 25

Toxic ingestions
Severely painful conditions
Multiple organ system involvement
Abnormal, non-emergency vital sign or test result

Question 26

Describe Semi-Urgent or Level 4 Status in ED Triage

Answer 26

Complaint or condition require assessment and intervention within 1-2 hours

Question 27

Examples of Semi-Urgent or Level 4 Status

Answer 27

Lacerations
Long bone fractures
Dislocations without neuromuscular compromise

Question 28

Describe Non-Urgent or Level 5 Status in ED Triage

Answer 28

Complaint or condition requires assessment and intervention within 2-4 hours or longer

Question 29

Examples of Non-Urgent or Level 5 Status

Answer 29

Suture removal
Wound recheck
Minor rash