Emergency Departments and Triage

Abdus Salam Khan, MD FACP
April, 2017

Emergency department is unique in the sense that it caters to everyone who thinks the problem needs to be addressed right away. The present with diverse complaints and varying degree of illnesses. In order to treat everyone in a safer way the emergency department creates different ways to handle all work load. The essence of this working is triage.

Triage is a French word which means to sort out or to prioritise. In other words the emergency staff has to quickly asses which patients are sick and should not wait and which ones can. This  practice actually balances the load of work with available resources in emergency department. With out this system in place all sick patients could get neglected while waiting for their turn to be seen by the doctor.

Things are seen to be changing for good in Pakistan. Doctors and administrators  are getting involved in talks about improving emergency departments and emergency care. We have three programs in Pakistan which train people for the emergency medicine. The first fellow of emergency medicine trained in Pakistan is out. This number is bound to increase year over year and this will certainly being a change in the level of care imparted in the emergency departments across nation.

By my experience in my own department and in other areas I have come to the conclusion that triaging patients at the front door of the emergency department is the key to patients safety and good care provision. This single change associated with processes to support it can be seen as the game changer for the dynamics of emergency department care. Through this  intervention sick patients will be identified and attended early resulting in better outcome and safe delivery of care.

Emergency severity index has been tried throughout USA and it has proven it’s worth. In Pakistan there are two emergency departments who use the emergency severity index to triage the patients. Now Asad Kashmir government has taken the initiative to implement the ESI in pursuit of improving the care in all emergency departments of AJK. Although it is a difficult task because of resource constraints, yet we are confident that it will still improve the patients satisfaction and level of care. Once successful we can duplicate this model for the entire nation.

Looking forward to the successful intervention and positive feedback. I can be reached at askhan65@yahoo.com

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