A & E Triage Data - FOI Response Register

Please provide the following information:

1. An account of how someone in your health board is triaged/catalogued upon arrival at A&E. Please include a chronological description of the process, which people the new arrival sees, what information about them is collected, and what judgements are made and recorded by the people they see (e.g. receptionist and triage nurse).

Patient arrives in A&E – either walks in or ambulance arrival

Taken to triage room or cubicle by staff nurse or ANP - SBAR (Situation, Background, Assessment, Recommendation) assessment of patients attendance, including nature of presentation, history, past medical history, current medications and allergies, observations, pain score.  All demographic information also collected by nursing staff, no clerking staff within A&E.

If arrival is by ambulance, ATMIST (Age, Time (of incident), Mechanism (of injury), Injuries, (vital) Signs, Treatments) form will have been received by ambulance radio located in reception, details then passed to A&E nursing staff who can decide if patient requires cubicle or resus on arrival depending on information given on ATMIST form, taken to appropriate space again dependent on presenting complaint – handover from ambulance crew to nursing staff – then SBAR assessment as above.

Triage into specific category depending on findings above – see next question

Triages to surgical or medical dependent on presenting complaint.

Referred to ANP, ENP or doctor for further assessment

2. If new arrivals are recorded into discrete categories upon arrival (for example by severity of condition), please outline that process and what those categories are.

We have 4 triage categories which are used within our A&E department as follows:

Triage 1 – immediate life threatening situation – assessment immediately by Doctor/Consultant

Triage 2 – Urgent – requires assessment by doctor within 10-20 minutes of arrival

Triage 3 – Minor – Not life or limb threatening, can wait to be assessed

R – Redirect – following triage patient does not require to be seen as an accident or emergency – patient to be sign posted to appropriate place i.e. GP, pharmacy, optician, self-care. 

3. Please provide a breakdown, from 2018 to present, annually, of how many total A&E patient arrivals your health board had, and how many were sorted into each of the categories.

Breakdown provided by Triage Category.

4. Please provide the instructional information given to triage nurses determining how they are supposed to categorise new arrivals. What exact criteria are judged, or at least supposed to be judged, when assessing a new arrival?

As stated in question one, patients are triaged by assessing various components, all patient presentations are based on an individual basis.

Patients are categorised into medical or surgical dependent on their presenting complaint