Triage: making the simple complex?

One of the hallmarks of an emergency department (ED), compared with an urgent care, or a physician's office, is that patients are seen by the clinicians in order of acuity, not arrival. When there are plenty of caretakers and few patients, determining the order is less important; everyone gets seen quickly. But when there are more patients than there are staff, some form of prioritisation is needed to prevent a critically ill patient deteriorating in the waiting room. Thus, triage is a critical need when there are not enough clinicians to go around. And as our departments become more and more crowded, our waits longer, there appears to be a greater and greater need for triage.

At the same time, triage itself, or at least the way we are told to practise it, also soaks up resources. In most EDs where emergency medicine is practised, one form or another of...

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