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Triage Flashcards

1
Q

4 decision points

A
  1. Is the patient dying
  2. Is this a pt who shouldn’t wait ?
  3. How many resources does this pt need ?
  4. VS
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2
Q

ESI 1

A

Does the person need immediate saving intervention?
Airway
Breathing or
Circulation

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3
Q

Criteria for meeting esi 1

A 
Need immediate airway, medication or hemodynamic intervention 
Already intubated 
Apneic 
Pulseless 
Severe resp distress
Spo2 <90%
Acute mental status changes 
Unresponsive (nonverbal and not following commands acutely or req noxious stimuli)
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4
Q

Examples of immediate life saving airway/breathing

A

BVM
Emergent cpap bipap
Surgical airway
Intubation

Not life saving - nc and nonrebreather

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5
Q

Electrical life saving

A

Defib
Cardioversion
Pacing

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6
Q

Procedures (lifesaving )

A

Chest needle decompression
Open thoracotomy
Pericardiocentesis
IO

Non life saving - diagnostics

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7
Q

Hemodynamics

A

IV resusc (significant )
Blood admin
Control of major bleeding

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8
Q

Life saving meds

A 
Narcan 
Adenosine 
D50
Dopamine
Atropine

Not lifesaving - asa heparin abx RT tx IV nitro pain meds

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9
Q

Examples of esi 1

A

Cardiac arrest, resp arrest , spo2 <90, trauma unresponsive , od rr <6 , anaphylaxis , hypoglycemia with ams , hypovolemia with pale , diaphoretic, no <70/palp, hr 30 weak and dizzy, severe Brady/tachy with signs of hypoperfusion

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10
Q

Decision point B

A

Would I use my last open bed for this pt?
Can this pt wait to be seen?
Is this a high risk situation?
Or
Is this patient confused, lethargic, or disoriented ? New onset or chronic ?
Or
Is this pt in severe pain or distress ?

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11
Q

ESI 2 cardiac

A

Suspicion of ACS

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12
Q

EENT esi 2

A

Epiglottitis
Peritonsillar abscess
(High risk situation )
Inhalation injury

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13
Q

Genitourinary esi 2

A

Testicular torsion
Dialysis pt not able to be dialyzed
Inability to urinate and needing Cath

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14
Q

Mental health esi 2

A

Danger to self or others
Si/ hi / psychotic / violent /elopement risk

Intoxication alone is not esi 2

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15
Q

Neuro esi 2

A

Severe headache with mental status changes , high bp, fever, lethargy, or rash
Sudden onset speech deficits or weakness
No hx ha with sudden onset ha concerning for subarachnoid

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16
Q

On/gyn

Esi 2

A

Late pregnancy: abruptio placentae and placenta previa

Early pregnancy:
Ectopic pregnancy

Postpartum heavy vag bleed

17
Q

Abruptio placentae s/sx

A

Bleeding, contractions, fetal distress

In second half of pregnancy

18
Q

Placenta previa s/sx

A

Painless vag bleeding

Most likely 3rd trimester

19
Q

Ectopic pregnancy s/sx

A

Amenorrhea
Vag bleeding
Abd pain

Less classic sx : painful fetal movements , nausea , dizziness/weakness, fever , flu sx , vomiting , syncope, cardiac arrest

20
Q

Ortho esi 2

A

Compartment syndrome
Inj with neurovasc impairment
Partial / complete amputations
Trauma mech with high accel or decel mech
Pelvis , femur and hip can present with a lot of blood loss

21
Q

Peds ESI 2

A 
Seizures 
Sepsis 
Dehydration 
DKA 
Burns 
Child abuse 
Head trauma 
Accidental OD (even vitamin)
Infant <28 days with fever >100.4
22
Q

Resp esi 2

A

Resp distress - asthma , PE, pleasurable effusion, pneumo, aspiration of fb , smoke inhalation , sob with cp

23
Q

Other esi 2 (high risk situations )

A 
DKA 
hyper or hypoglycemia 
Sepsis 
Syncope or near syncope 
Electrolyte disturbances
24
Q

Abd high risk situation examples

A

Abd pain in elderly

GIB

25
Q

Cardiac esi 2 examples

A

CP, arterial occlusion , cp with prior stent , pericarp effusion
Infective endocarditis

26
Q

General esi 2

A

Immunocompeomised
Organ transplant
Onc pts

27
Q

Esi 2 GU examples

A 
Testicular torsion (sudden onset testicular pain)
Renal failure unable to be dialyzed
28
Q

Gyn esi 2 examples

A

Ectopic

Spontaneous abortion

29
Q

Mental health esi examples

A

SI
HI
Combative , hostile , hysterical, etoh w trauma
Any sexual assault

30
Q

Neuro esi 2 examples

A

Rule out meningitis (h/a, fever, lethargy)
Hx multiple cva
Acute ischemic stroke (motor or speech deficits )

31
Q

Peds esi 2 examples

A

V/d unable to eat , asthma attack

32
Q

Resp esi 2 ex

A 
Acute epiglottitis (drooling)
Severe asthma (severe sob)
Pleural effusions (severe sob)
Spontaneous pneumo (sudden onset sob)
33
Q

Trauma esi 2 ex

A

Mva with transient loc

Stab to groin

34
Q

Esi pain

A

7 or higher is severe

35
Q

What is an esi resource ?

A

Labs
ECG , X-ray, CT, US, MRI
IV fluids (lock not a resource )
Meds (IV IM or nebs)- tetanus excluded
Specialty consult (not pcp)
Simple procedure = 1 (lac repair, Foley Cath)
Complex procedure = 2 (conscious sedation)

36
Q

What is not a resource ?

A 
Lock 
Po med 
Tetanus vaccine 
Wound care 
Dressing , splint , sling crutches 
Poc tests 
Pelvic exam 
Cardiac monitoring

Triage (1 decks)

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