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Two patients arrive at the ER for emergency care:

1. A 28-year-old female who cut herself while cooking. The cut on her left index finger appears to be to the bone and is bleeding profusely.

2. A 63-year-old male with chest pains, shortness of breath, and numbness in his left arm.

Which patient do you prioritize and why?

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Triaging patients requires difficult decision-making, often under time pressure. It is not always a simple black-and-white decision about whether someone needs care. Everyone who enters the ER needs care, but some conditions are critical and more time sensitive than others.

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Lowest priority; minor conditions which are not time-sensitive and care is not needed immediately

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Care is needed but can wait if other higher priority patients exist

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Care needed quickly but can be delayed temporarily

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Highest priority; care needed immediately as the patient may not survive without treatment

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1. Triage
2. Physical exam and diagnostic testing
3. Medical treatment and reevaluation
4. Admission to hospital or discharge to home

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Patients get care in the order of priority assigned. They will have a physical examination including measurement of vital signs. Any diagnostic testing needed will be completed to develop a treatment plan. The patient’s condition may then be reevaluated, and a decision will be made about whether to admit them to the hospital or discharge them.

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In some settings, triage nurses also help with initial care for patients, such as exams and identifying or carrying out diagnostic interventions, such as x-rays, blood work, urinalysis, and tests for pathogens like bacteria and viruses.

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Often trained and licensed as a registered nurse (RN), a triage nurse in an emergency room is an experienced nurse who makes decisions around the urgency of a patient’s need for care, assigning each patient with a triage category. A triage nurse needs to be calm under pressure and able to think critically to make decisions quickly.

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Patients in need of resuscitation—immediate, life-saving treatments such as cardiopulmonary resuscitation (CPR) and/or the use of an automated external defibrillator (AED)—are the top priority.

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The sorting and prioritization of patients based on the urgency of their need for care.