©ESI Triage Research Team, 2004. Reproduced with permission.
A. Immediate life-saving intervention required: airway, emergency medications, or
other hemodynamic interventions (IV, supplemental O2, monitor, ECG or labs DO
NOT count); and/or any of the following clinical conditions: intubated, apneic,
pulseless, severe respiratory distress, SPO2<90, acute mental status changes, or
unresponsive.
Unresponsiveness is defined as a patient that is either:
B. High risk situation is a patient you would put in your last open bed.
Severe pain/distress is determined by clinical observation and/or patient rating of greater than or equal to 7 on 0-10 pain scale.
C. Resources: Count the number of different types of resources, not the individual tests or x-rays (examples: CBC, electrolytes and coags equals one resource; CBC plus chest x-ray equals two resources).
Resources | Not Resources |
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D. Danger Zone Vital Signs. Consider uptriage to ESI 2 if any vital sign criterion is exceeded.
Pediatric Fever Considerations:
©ESI Triage Research Team, 2004 (Refer to teaching materials for further clarification)
AHRQ Publication No. 05-0046-2
Current as of May 2005
Internet Citation:
Gilboy N, Tanabe P, Travers DA, Rosenau AM, Eitel DR. Emergency Severity Index, Version 4. Implementation Handbook. AHRQ Publication No. 05-0046-2, May 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/esi/
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