Top Five Tips for Emergency Triage

By Aiden Masri, DVM
angell.org/emergency
emergency@angell.org
781-902-8400

April 2024

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Introduction

In an emergency setting, it’s not uncommon to have a list of patients waiting to be seen. A dog comes in with a bleeding torn nail, a cat is here for vomiting, and a snake is here for not eating for the past three weeks. How do you know which of these patients needs to be seen first? The triage process helps decide the order in which patients are seen. Some need to be rushed to diagnostics and initiate treatments immediately, while others are stable enough to wait and be evaluated once the more critical patients are stabilized.

The triage process involves collecting a visual assessment of each patient waiting along with their basic vital parameters (heart rate, respiratory rate and effort, and body temperature). If these values are abnormal, or a pet is not appropriately responsive during their triage, they move up to a higher priority on the list.

If you are part of the triage process, it is essential to know where to direct your focus; keeping the following five tips in mind can help the triage process run as smoothly as possible.

Tip #1 – Keep Safety in Mind

In any veterinary setting, numerous work hazards exist, including the potential for infectious diseases, the handling of sharp instruments, and the presence of patients who may bite or scratch. It is important to keep your hospital’s safety protocols in mind to keep yourself, other staff, owners, and all the patients under your care safe. This includes recognizing patients who may be showing signs of pain or fear-based aggression that are more likely to bite or scratch when handled and keeping in mind quarantine protocols for pets exhibiting signs of infectious diseases.

Tip #2 – Remain Calm

While it can be easy to become overwhelmed, developing a process to remain calm and having a systematic approach during patient assessment will allow each pet to be evaluated thoroughly and prevent mistakes associated with attempting to rush. Using a checklist during this process can also help ensure that the triage process goes as smoothly as possible and reducing stress for staff, owners, and pets.

Tip #3 – Recognize “Red Flags”

When you are the first person evaluating a pet coming in through the ER, you play an essential role in helping to assess whether or not they are stable enough to wait or need to be seen more urgently. Knowing normal vital parameters and behavior for every species that your hospital sees through their ER is vital in the triage process. If you have concerns about a pet during their triage evaluation, don’t hesitate to bring these concerns to the attention of other team members so that these patients are evaluated sooner. Regardless of species, if a pet is ever minimally responsive, having trouble breathing, actively bleeding, or uncontrollably painful, these patients should be evaluated immediately.

Tip #4 – Build Strong Relationships

Building a sense of trust with your team is essential to having a smooth-running emergency room. This allows all team members to be more comfortable, no matter their skill or experience.

Tip #5 – Remember Self-Care

Keep yourself in mind, too! It can be easy to forget about yourself during a busy shift, and some days can fly by so quickly that you realize you’ve barely had a chance for a break. It is also essential to pay attention to your own needs and ensure you have time during each shift for food, water, and a chance to take a deep breath.