Advanced Triage Technologies - An Overview

Introduction

In case of mass calamities, an emergency department overcrowded with critically ill and morbid patients faces severe crises as the workload is immense and the resources and the available manpower fall short to meet the increasing needs. Paying attention and providing optimum care to each and every patient in such a situation seems highly impossible. To tackle such a situation, the triaging system came into existence, which differentiates and prioritizes the treatment needs of the groups that respond immediately over the ones who fail to respond even after providing optimum medical care.

What Is Triaging?

It is the process in which the patients are examined quickly in the hospital setup and given priority based on the severity of the injury and the necessity of the treatment, which helps save more lives. The priority depends on the severity or illness of the disease, prognosis, and availability of the resources.

How Does Triage System Work?

The system mainly works on the prioritization principle, which helps in differentiating the patient needs in mass casualties like terror attacks, war fields, and emergency departments in hospitals. Triaging is done by using a color-coding system, which is as follows:

• Red: Symbolizes the patients suffering from life-threatening emergencies requiring immediate medical care.

• Yellow: Indicate patients who suffer grievous injuries and require immediate attention. Sometimes, these patients are prioritized for medical care as they have more chances of survival than the red-flagged group.

• Green: This indicates less serious injuries that are not life-threatening. Hence, transport to the hospital can be delayed.

• Black: This group consists of patients who are brutally wounded with very low chances of survival. They are not given priority as they are already comorbid and do not respond to the treatment. Hence, the priority is given to other groups who respond well to the treatment and survive.

• White: The patient has not sustained any injury or illness.

How Does Advanced Triage (AT) System Work?

• Implementing the advanced triage protocols helps manage the workload in the emergency departments during the casualties.

• Advanced triage (AT) is carried out by nurses by adopting the clinical guidelines devised by the multidisciplinary team in the hospital.

• The nurses act independently in the hospital setup and primary health care once the patients are triaged priorly.

• The nurse carries out a complete examination and intervenes using pharmacological and non-pharmacological methods in the emergency department and then refers to the physician.

• The nurses in the emergency department are also trained to carry out a detailed assessment of the patient and advise diagnostic tests to arrive at the diagnosis. This step requires a physician’s supervision.

• The patients are referred to the physicians in case of diagnostic and therapeutic complexities, or an evaluation by a doctor is required.

What Are the Advantages of Advanced Triaging In the Emergency Department?

• Achieves patient comfort and satisfaction.

• Less time is required for drug administration.

• Favors timely diagnosis and treatment of the patients.

• Reduces waiting time, which prevents anxiety and distress among the family members.

• Increased efficacy of the treatment in the emergency department.

• Reduced length of hospital stays owing to a swift investigation process where nurses investigate blood tests and X-rays under the guidance of emergency physicians.

How Does the Advanced Triaging System Benefit the Emergency Department?

The mainstay of the advanced triage protocol (ATP) is to enable the triage professional to assess the patient and intervene with diagnostic and therapeutic approaches by adhering to the principles even before the patient is seen by the emergency physician, which directly influences the hospital stays. By adopting the advanced triage protocols, the following benefits can be availed:

1. Length of the Hospital Stay:

• Advanced triage technologies greatly influence the length of hospital stays as the triage professionals are well-trained to diagnose and provide basic therapeutic interventions before the patient is seen by the doctor.

• This prevents patients from waiting for longer periods in the waiting rooms and is ready for further treatment with the laboratory test results in the first appointment with the physician.

• The ATPs (advanced triage protocol) aim to train the triage professional to be qualified enough to carry out the diagnostic and therapeutic procedures, thereby reducing the overcrowding of emergency departments in hospitals.

2. Patient and Professional Satisfaction:

• Many recent studies have documented the importance of adopting ATPs in improving the patient’s and the clinician’s experience with the triaging system.

• The patient’s and the professional’s satisfaction with the emergency care catered through the triaging system indicates the quality of the service rendered.

• ATP prevents the overcrowding of the emergency department, which positively influences patient and professional satisfaction.

3. Efficacy of the Treatment:

• The efficacy of the treatment carried out through advanced triage technologies can be increased by conducting periodic training for triage professionals and nurses.

• Adequate training equips the triage professionals with a sound knowledge of diagnostic and therapeutic approaches, which thereby prevents unnecessary ordering of laboratory tests.

• This enhances the performance of the medical team involved in catering medical care to the casualty victims and also ensures the safety of the triage professionals involved.

• These advanced triage strategies encourage the nurses and other triage professionals to build technical competencies and learn autonomous decision-making in grave situations, contributing to effective treatment outcomes.

Conclusion

The advanced triage strategies aim to prevent overcrowding of the hospitals and emergency departments at times of mass casualties by rendering optimum and timely intervention to patients through trained nurses and triage professionals. Many studies have proven the decrease in mortality rates as optimum care is delivered by priority so that the ones who need the treatment the most are attended to in no time. The reduction in overcrowding has resulted in greater patient and professional satisfaction, indicating the quality of the treatment rendered. The training provided equips the triage professionals with more confidence and knowledge to deal with the casualties, aiding in effective triage management.