DaveC

We are not looking for recommendations for primary triage methodologies used in the field like SMART or START or MET TAGS. We are looking for an algorithm that captures the prioritization process similar to what a triage nurse in an ED would go through. At a recent Table Top Exercise our MRC Unit was tasked with setting up an alternate care facility (ACF) that would receive self-presenting patients, no ambulance deliveries. The ACF was needed because none of the four local hospitals could accept any patients. Our ACF would act like an emergency department or a freestanding emergency clinic, receiving patients who need to be evaluated to determine if they can be treated in our ACF or if they need to be transferred to other ACFs more geared to higher levels of definitive care (ex. DMAT's field hospital). After that initial "ship or treat" sorting out is done, we need to classify our patients into treatment priority groups so the medical staff can focus on the higher priority patients, again like is done in a hospital ED. There is a great comparative study in the online Agency for Healthcare Research and Quality (AHRQ Home>Quality Assesment>Measuring Healthcare Quality> Emergency Severity Index Version 4). The best contender I've found is the Emergency Severity Index (ESI) (Gilboy et al., 1999; Wuerz, Eitel, Travers & Gilboy, 2000). But we are really looking for actual field experiences of other MRC units not hypotheticals. We are not looking for recommendations for primary triage methodologies used in the field like SMART or START or MET TAGS. We are looking for an algorithm that captures the prioritization process similar to what a triage nurse in an ED would go through. We are looking for folks that will share their actual experiences with any system they have used, good, bad or otherwise. THANKS Again ! David Courter, Advanced EMT EMS Unit Lead Capitol Region MRC 860-529-9098 decourter@cox.net