TRIAGE TUESDAY
Goal:
To
have EMS Transport Services and hospitals periodically (on a given day) use
triage tags in conjunction with their START and JumpSTART triaging skills so
that there is enhanced competency and capability of both EMS and hospitals in
managing trauma victims during a real time incident.
Objectives:
1.
EMS Transport services will use “Triage Tuesday” to test
their triage training periodically (on a given day as determined by the RTAC)
by using triage tags for all patients, transported to the hospital
2.
Hospitals will use “Triage Tuesday” by using triage
tags for all patients, presenting to the ED, periodically (on a given day as
determined by the RTAC), to increase their knowledge and comfort with triage
tags and the patient priority, based on the triage colors for severity.
Process:
1.
Triage Tuesday will occur on a designated day (example:
3rd Tuesday of every month) as determined by the EMS Transport Services and
hospitals in each RTAC.
2. EMS Transport Services will use a triage tag on all patients, transported to the ED.
3.
Hospitals and EMS Transport will also use a triage tag
on all patients[1], presenting
to the ED. Hospitals may want to provide patients that receive a tag with an
informational piece to explain to them why they are being tagged (see Attachment A: Information for Patients)
4.
There is no need to retain the tags.
5.
At the hospital, the trauma coordinator or designee or
at the EMS Transport, the Medical Director or designee, will help promote “Triage
Tuesday”.
6.
Hospitals are to use the triage tags to achieve the
following purposes:
a.
to determine if the triage tag color code used by the
EMS Transport Service was also the triage decision made by the ED staff
b.
to determine whether the information provided on the
triage tag was helpful to the ED staff
c. to determine from the ED staff perspective what enhancements can be made to the triage tagging process to help improve patient care in the field, during transport and at the hospital
Note: This analysis
is not meant to be judgmental, but to familiarize both
7. EMS Transport Services are to use the triage tags to achieve the following purposes:
a.
to determine issues that
b.
to determine what information is most critical to
capture if there are constraints with entering all the information
8.
The EMS Transport Services and Hospital are to discuss
issues that result from “Triage Tuesday” at the RTAC meeting.
9.
The RTAC Coordinators will identify any statewide
issues that should be brought to the attention of the State Trauma Advisory
Council and/or the EMS Board.
Action Steps:
1.
It is recommended that EMS Transport Services and
hospitals, for the purposes of “Triage Tuesday” use the California Firefighters
Triage Tag[2].
(see Attachment B: Triage Tag Criteria).
2.
The RTAC Coordinators will supply both EMS Transport
Services and hospitals with tags for “Triage Tuesday” at no cost[3].
3. “Triage Tuesday” is a voluntary effort. Each RTAC will consider what options are available for any area where a hospital or EMS Transport Service does not want to participate.
It is
encouraged that both the hospital and the EMS Transport promote their
participation in “Triage Tuesday” through the media so that the community is
aware of these emergency preparedness efforts that hospitals and
Attachment A: Information for Patients
All patients who come to the Emergency department today will receive a “triage tag”.
All hospitals and EMS Transport services are participating in what is called “Triage Tuesday”. On this given day, all patients, being transported to the hospital by an ambulance and all patients, who come to the Emergency Department, will be “tagged.”
“Triage” is a French word that means “to sort”. It is a process that occurs daily with every ambulance and every Emergency Departments in the country, but usually “tags” are not involved. All patients are “triaged” so that those most in need of medical care receive it first.
In an
incident where there are many patients involved a triage tag will better help
both EMS ambulances and hospital emergency departments to take better care of
you, your loved one and neighbors. The tag will help all involved in your care
to better identify the type of care that you need and make sure that those most
in need of care receive it first.
Attachment B: Criteria for Triage Tags
From the
The goal is to have consistent tagging and tracking
protocols across the state. We all have the responsibility to answer the
question: “Where is my loved one?” Initial discussion of critical information
needed to accomplish this includes:
a. there
needs to be a connection between the triage tag # and any # issued by the
hospital(s)
b. tag/tracking
must be based on START triage protocols
c. tag
is to include chemical symptomology and treatment, if applicable
d. tag
is to incorporate whether personal belongings/valuables are being transported
with patient or, if not, how to identify location of these belongings/valuables
e. the
tag is to include a cross reference to other patients on scene triaged/treated/transferred,
who may be related to the patient tagged
f.
the tag is to identify if the patient is a special
needs group
It was agreed that no tag can contain everything needed, but
we need to think “outside the box” and then identify those items that are
critical high priorities. No decision will be made on tagging/tracking
protocols until there is involvement of all key constituents.
From the
The
HRSA Leadership Group encouraged the RTACs are taking the lead on this issue.
Issues to consider include:
a.
Red
Cross needs to be involved in patient tracking
b.
With
different tags being used, the same patient identifying number may appear at various
hospitals
c.
How can
hospitals use their tag # to correlate to the hospital Medical Record system #
d.
There is
a need for a unique identifier
It
was recommended that a State Expert Panel be established to address
tagging/tracking from the hospital perspective. This will include answering the
following questions:
a. How
do hospitals cooperate in answering the question “Where can I find my loved
one?”
b.
What information is absolutely critical for the
hospital when the patient is brought in from the field?
c.
How can a patient tracking (numbering) system be
devised so that a patient can be tracked from the field to the hospital to
other referral hospitals or other destinations?
Appendix C: Template News Release
|
The following sample news release. Feel free to use all or some of the material and adapt it as you see fit to your community. |
Using
realistic training everyday—TRIAGE TUESDAY!!
If you or a family member are brought to a local hospital by
ambulance, you may be wearing a tag! This would be a “triage tag” primarily
used in mass casualty incidents (MCI).
All hospitals and Emergency Medical Services (EMS) transport
services have the opportunity to participate in a new educational experience
known as “Triage Tuesday.” On a given day, all patients being transported to
the hospital by ambulance or who present to the Emergency Department for
treatment will be “tagged.”
“Triage” is a French word that means “to sort”. It is a
process that occurs daily with every ambulance and every Emergency Department
in the country. All patients are “triaged” so that those most in need of
emergent medical care receive it first, but usually “tags” are not involved.
“In an incident where there are many patients involved, a
triage tag will help both
“When there is an incident, involving many people, EMS and
First responders must act quickly to identify those most in need of
immediate treatment,” said (name)of
(name)Ambulance Company. “By tagging patients, we are “triaging” (sorting) the
patients and identifying them by a color-code. When there is little time for
communication, the triage tag will be a visual sign telling everyone involved
the urgency of treatment to the patient.”
Triage
Tuesday is sponsored by the (name) Regional Trauma Advisory Council (RTAC),
whose mission is to improve care of those injured and work toward reducing
injury. The Regional Hospital Disaster
Preparedness Board, whose mission is to assist hospitals in preparing to care
for patients, involved in a mass casualty incident or other public health
emergency also support this effort.
For further information about Triage Tuesday, please contact
(name) at (telephone or email or address).
[1] Although it is the ideal to place the triage tag on the patient, the hospital or EMS Transport may also choose to place the tag on the patient’s chart, if it is felt that the tag may cause the patient anxiety or if staff does not have time to answer questions about the tag.
[2] The RTAC will supply all hospitals and EMS Transport units in its region with the California Firefighters triage tag at no cost. Hospitals and EMS Transport may choose to use tags that they have in stock or are familiar with. The goal is to come to consensus as a state on either one tag that is used by all or to have multiple tags that meet certain criteria to achieve this consistency
[3] The triage tags are funded through the FY 2005 HRSA Hospital Disaster Preparedness Cooperative Agreement.