TL;DR
Triage: Patient prioritization using START (Simple Triage and Rapid Treatment) when resources are insufficient.
Triage
Definition
Patient prioritization using START (Simple Triage and Rapid Treatment) when resources are insufficient.
Calculation Methods
Dosage calculations related to triage in EMS:
- adenosine: 6mg rapid IV push, then 12mg if needed (IV rapid push with flush)
- midazolam: 2-5mg IV/IM, 0.2mg/kg IN (IV, IM, IN)
- aspirin: 324mg PO chewed (PO)
Pediatric dosing: always calculate by weight (mg/kg). Use Broselow tape if weight is unknown.
Regulatory Context
Regulatory context for triage includes federal and state requirements. Healthcare facilities must comply with CMS Conditions of Participation, state licensure requirements, and accreditation standards (Joint Commission or AAAHC). Non-compliance can result in citations, fines, or loss of Medicare/Medicaid reimbursement.
Troubleshooting
Troubleshooting triage in the field:
- AED: If automated external defibrillator for vf/pvt fails, verify connections, check battery, try alternate equipment. Available sizes: Adult pads (over 8yo or 25kg), Pediatric pads (under 8yo or 25kg)
- Pulse oximeter: If measures spo2 via infrared absorption through capillary bed fails, verify connections, check battery, try alternate equipment. Available sizes: Finger clip, Earlobe, Pediatric wrap
- King airway: If supraglottic blind-insertion airway device fails, verify connections, check battery, try alternate equipment. Available sizes: Size 3 (4-5 ft), Size 4 (5-6 ft), Size 5 (over 6 ft)
Clinical Significance
In prehospital care, understanding triage can mean the difference between a positive patient outcome and a critical miss. An elderly woman found on the floor after a fall. Alert but confused, hip pain with external rotation and shortening of right leg. Suspect hip fracture: splint in position found, monitor for shock.
Related pharmacology: albuterol at 2.5mg nebulized, can repeat, indicated for Bronchospasm, asthma, COPD.
Exam Focus Areas
On the Nremt Emt, Nremt Paramedic exam(s), questions about triage typically test:
- Correct medication selection, dosing, and route of administration
- Recognition of signs and symptoms requiring immediate intervention
- Assessment findings that differentiate between similar presentations
Why It Matters
Triage color-coding (red/yellow/green/black) tested on EMT and Paramedic exams.
Related Terms
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