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Emergency Severity Index Triage Training

UNION HOSPITAL

EMERGENCY ROOM

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What is ESI?

Emergency Severity Index

A five level triage scale that uses prioritization based on urgency (acuity) of condition but also considers resources needed to get the patient thru to ED disposition.

Endorsed by ACEP and ENA.

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So, a 5 Level rating?

5 levels have meaningful differences between each level compared to previous 3 Level systems.

ESI levels can be used to describe acuity levels. Not only # of visits annually but # of each level of patient.

Can be used to justify staffing. 5 Level is research based, standardized and

reliable between users.

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Emergency Severity IndexESI

• Acuity assessment

- Airway, breathing, circulation

- Potential for life, organ or limb threat

- How soon the patient needs to be seen

• Expected resource assessment

- Number of resources, as estimated by the

triage nurse, that a patient is expected to

consume in order for a disposition decision.

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Emergency Severity IndexESI

Five explicitly defined categories Mutually exclusive

Allows for rapid sorting

Differs from a complete assessmentGathering sufficient information to assign an ESI levelQuick sorting

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ESI ALGORITHIM

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Resource Examples

CBC,BMP, PT/PTT=One Resource CBC, CXR=Two Resources CXR, ABD Series=One Resource CXR,CT Scan=Two Resources CBC,CT Scan, EKG=Three Resources

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Frequently Asked Questions

• Why isn’t a splint a resource? The application of a simple, pre-formed splint is not considered a resource. This is not being used to make the disposition decision. The Xray showing the injury makes the dispo decision.

• Why are the following considered resources? Eye irrigation, nebulized meds, and blood transfusion. All three are considered resources for the purposes of ESI. They tend to be used on patients that are more acute, require significant ED time, and are likely to have longer LOS.