Triage for Veterinary Patients

This study composed a list of veterinary triage discriminators and attempted to determine whether its application could result in more accurate categorization of emergent patients than could intuitive triage. The veterinary triage list (VTL) used as a model the Manchester triage system, a system with 5 categories—red (immediate), orange (very urgent), yellow (urgent), green (standard), blue (nonurgent)—each assigned with a maximum target waiting time (TWT).

TWT categories included 0, 15, 30–60, and 120 minutes and were associated with triage categories red, orange, yellow, and green, respectively. TWTs were prospectively determined by veterinary nurses (TWT-N) and were estimated based on owner-provided history and visual inspection. A second TWT assessment was performed by the review team (TWT-R). The study group was also retrospectively triaged by the main investigator using the VTL (TWT-VTL). Results for TWT-N and TWT-VTL were compared with those from TWT-R. Intuitive triage by nurses showed significantly less correlation to TWT-R than did triage performed with VTL.

Specific training for veterinary nurses and emergency doctors in performing triage and implementing a standardized triage system was likely to result in more appropriate TWTs for emergency patients.

CommentaryThis study compared traditional (ie, intuitive) triage methods with a method using a triage score. Human triage scores were modified to fit emergent veterinary patients. The score had 68 total discriminators divided into 8 subcategories. The study found that traditional triage was much more likely to “under-triage” more emergent patients, as compared with the retrospective evaluation of cases using the formulated triage score. Traditional triage may not have included an emergent physical examination. Although the triage score has many discriminators and may require more time, it was more likely to result in a correct triage category. An emergent physical examination was also recommended, as parameters discovered during examination can impact the triage score, allowing  recognition of more unstable patients.—Lisa Powell, DVM, DACVECC

SourceEvaluation of a veterinary triage list modified from a human five-point triage system in 485 dogs and cats. Ruys LJ, Gunning M, Teske E, et al. JVECC 22:303-312, 2012.

This capsule is part of the One Health Initiative