Pediatric emergency medicine trisk 0138 0138
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testing for those awaiting ED room placement, or could treat and discharge lower
acuity patients from the waiting area itself. Level of care and interventions will
depend upon the credentials of the provider (attending physician, nurse
practitioner, or physician’s assistant) and available team members and resources.
CONCLUSION
Children presenting to EDs bring unique challenges to the triage process.
Utilizing a standardized approach, such as the validated AHRQ ESI triage tool,
can improve the safe passage of the pediatric patient and family through triage. A
pediatric triage nurse must be aware of the different patient–family care
dynamics; communication challenges; and developmental, physical, mental, and
environmental needs of children. A comprehensive triage orientation includes
both didactic and hands-on review of pediatric considerations, the overall triage
process, and accurate assignment of acuity. Additionally, a quality assurance and
improvement program should monitor triage accuracy. Consideration should also
be given to patient flow processes through triage to ensure “right patient, right
provider, and right time.” The triage nurse has a critical responsibility for quality
and safety of the patient that begins at the time of patient entry to the ED. Triage
nurses must have experience, advanced assessment, and critical thinking skills.
Suggested Readings and Key References
American College of Emergency Physicians, Emergency Nurses Association,
Joint Statement by the American College of Emergency Physicians (ACEP)
and the Emergency Nurses Association (ENA). Triage Scale Standardization .
Irving, TX: American College of Emergency Physicians; 2010.
Barata I, Brown K, Fitzmaurice L, et al. Best practices for improving flow and
care of pediatric patients in the emergency department. Pediatrics
2015;135(1):e273–e283.
Centers for Medicare & Medicaid Services. Emergency medical treatment &
labor
act
(EMTALA).
CMS-1063F.
Available
at
.
Chameides L, Sampson R, Schexnayder S, et al., eds. Pediatric Advance Life
Support Provider Manual . Dallas, TX: Amer Heart Association; 2011.
Dieckmann RA, Brownstein D, Gausche-Hill M. The pediatric assessment
triangle: a novel approach for the rapid evaluation of children. Pediatr Emerg
Care 2010;26(4):312–315.
