The patient is a 72-year-old Samoan female of Non-English Speaking Background (NESB) who had been discharged from another hospital (Bankstown) in the last two weeks with a similar event. She was brought to the Emergency Department from home by the Ambulance Service. The patient was triaged as Category Two as per ATS criteria. The Australasian Triage Scale (ATS) was designed for hospital-based emergency services for Australia and New Zealand, and is a scale for rating the clinical urgency of patients (Policy). The ATS directly links a triage code with a range of outcome measures (inpatient length of stay, ICU admission, mortality rate) with resource utilization (staff time, cost) and allows for the analysis of several performance parameters in the Emergency Department (casemix, operational efficiency, effectiveness, utilisation review and cost).
The ATS is primarily a clinical tool and all patients presenting to an Emergency Room should be triaged on arrival by a specifically trained and experienced registered nurse, who will record the ATS code and triage assessment (Policy). The nurse should continue to monitor the patient, and if the symptoms change, then the patient should be re-triaged. The triage nurse should also initiate appropriate clinical investigations and management of the patient according to organisational guidelines. The ATS code is applied according to how long the patient should wait for medical assessment in the opinion of the triage nurse. In the case under consideration here, the patient was assigned to ATS category 2, which indicates she should be medically assessed within 10 minutes. This was appropriate since she was having problems with shortness of breath, a painful, productive cough, and was most likely suffering from pneumonia.
The patient complained of shortness of breath, fever, problems with asthma, and a painful, productive cough for the last day. She had been seen the day of her admis...