Triage Principles

How the programme is structured and assessed, and the two statements the whole course rests on. First: the ATS describes clinical URGENCY only - not severity, not complexity, not quality of care, not workload, not staffing. Almost every misuse of the scale is a version of forgetting that. Second: completing this course does not qualify anyone to triage. G24 requires staff who are both specifically trained AND experienced, and names the Emergency Triage Education Kit as the nationally recognised educational resource.

Also here: what this course is the theory underneath, what the other three requirements are and where you obtain them, and how the programme is measured. Read this section before Module 01 - the scope rule is what makes the rest of the course safe.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The definition, and the three functions. A triage system is a standardised method of rapidly determining the clinical urgency of all incoming patients - there is no category of patient who skips triage, not the regular attender, not the person who wants a certificate, not the patient a GP has already seen.

And the harder half: what the triage assessment is not intended to do. It is not intended to make a diagnosis. The output is a category. Also here: the separation of streaming and fast-tracking from the objective allocation of a category - two decisions, in a fixed order - and why category data cannot describe how busy a department was.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The five categories, their maximum treatment acuity times and their performance indicator thresholds. Category 1 immediate, 2 within 10 minutes, 3 within 30, 4 within 60, 5 within 120. These five figures are the only pure recall in the programme and you should leave this module able to say them without reference material.

Then the two rules that govern every allocation you will ever make. The most urgent clinical feature identified determines the category - you do not average features and you do not discount one because the rest looks reassuring. And absolute physiological measurements must not be taken as the sole criterion - the numbers are anchors, not triggers. Also: why Category 5's time is a different kind of statement from the other four, why the colours are an adjunct only, and why ACEM states plainly that reproducibility is never perfect.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The ETEK systematic approach, in five steps - and the first step is not the patient. It is checking and mitigating environmental red flags, which sits alongside G24's requirement that hospitals plan for aggression at triage as part of their obligation to provide a safe workplace.

Then the stop rule, which is what makes a two-minute triage possible: if you identify a feature requiring urgent intervention, you stop the assessment and assign the category. Completing a structured assessment on a patient who needs a resuscitation bay is the error, not the omission. Also: the two-to-five-minute standard and why both failure modes are clinical; what belongs to the treatment nurse rather than to you; and the final step, which has three parts and of which most clinicians remember only the first.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The time-critical end of the scale, and the descriptors that place a patient there. A patient identified as Category 1 or 2 is taken immediately into an appropriate assessment and treatment area - and where no area exists, that is an escalation, not a reason to change the category.

The module's real work is the three separate routes into Category 2, joined by 'or': imminently life-threatening, important time-critical treatment, or very severe pain. Most clinicians know only the first. And the route that catches people out - high-risk history, which is a Category 2 heading in its own right. A significant sedative ingestion, febrile neutropenia: patients whose urgency is entirely in the story and whose examination is completely normal.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

Where most of your patients actually are, and where almost all the difficulty is. The distinctions here usually turn on a modifier rather than on a different presentation - persistent versus not, with dehydration versus without, moderately severe versus moderate. Also the descriptors that lift a category on a single fact: abdominal pain in a patient over 65, and a stable neonate.

And category drift - why it happens mainly in these three categories, why it is cumulative and self-reinforcing, and why the defence is the descriptor. Nobody argues about a Category 1. Two orientations after drift starts, the department's Category 3 is the guideline's Category 2, and every figure in its performance report has become unreliable.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

Pain is a route into the scale in its own right, parallel to physiological threat. Very severe pain, any cause, is Category 2, and the guideline states that humane practice MANDATES its relief within ten minutes - whatever the underlying condition is, and whether or not it threatens life or limb.

Then the harder part: a patient who cannot self-report. Self-report is the gold standard and its absence is not the absence of pain; physiological signs are neither sensitive nor specific and their absence never excludes it. Also the frequent attender, and the difference between recording an observation and recording a verdict - one is clinical information, the other sits in that patient's record for years. And equity of triage scores across populations, which is one of the four things G24 says emergency departments should audit.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The rule this module exists for: where a patient presents with both a physical complaint and behavioural disturbance, the highest appropriate category based on the COMBINED presentation applies. The two are routinely triaged separately - the injury gets a category and the agitation gets a security response - which is exactly what the rule prevents.

Where a departmental mental health assessment tool sits: supportive to initial triage, and applied FOLLOWING formal triage assessment. Never instead of the category and never before it. Also: reported features carry categories just as observed ones do, so a calm, articulate patient who tells you something frightening has told you a Category 1 or 2 feature. And the four physical causes that hide behind agitation - with blood glucose and oxygen saturation as the two bedside tests that take under a minute between them.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

Three conventions, each of which exists because a group of patients is systematically under-triaged without it. All five categories are used in all settings where children are seen, whether the department is purely paediatric or mixed.

For older people: the physiological, behavioural and physical changes of ageing conceal serious pathology, which is why abdominal pain over 65 has its own descriptor and why a 'normal' blood pressure can be profound hypotension for that patient. For pregnancy: urgency is assessed for both the person who is pregnant and the foetus, and the higher governs. This programme states no age-specific paediatric vital sign thresholds - those come from your own department's observation charts, and a single printed set would be wrong for most ages.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

Re-triage has two triggers, not one: a change in the patient's condition, OR additional relevant information becoming available. The second is the one people forget - a call from a GP, a result, a relative arriving with a history, or the patient finally saying what they did not say at the desk. It can be actively sought, and a waiting room round is where you seek it.

When a waiting patient deteriorates and needs a more urgent category, the senior medical officer in charge of the ED, or their delegate, is notified IMMEDIATELY. A named role and a named timeframe. Also: what P06 requires of patients who remain waiting - a process AND staffing - why a did-not-wait is not a refusal of treatment, and why 'he didn't want to bother anyone' is a statement about the department rather than about the patient.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The essential elements of a triage record, including the one most often incomplete: a re-triage category recorded with the time AND the reason. 'Condition changed' is not a reason, and the reason is what makes the entry useful to anybody else.

Then the four things G24 says emergency departments should audit - high-risk outcomes; deterioration prior to medical assessment or treatment; equity of triage scores across populations; and patient experience measures - and how to read a category distribution against peer hospitals of the same role delineation. And safety at the desk, which G24 addresses to jurisdictional managers and hospital administrators as a workplace obligation: a triage clinician who is assaulted has not failed to de-escalate.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The assessment brief, the printable case study assessment and the printable summative paper. The interactive versions live here too - the case study assessment as a branching activity, and the summative assessment in the platform's own engine.

Five unfolding cases across 25 branching decisions, formative and not graded - every option carries feedback, including the plausible wrong ones, which is where most of the learning is. Then 60 single-best-answer items blueprinted across all eleven modules. 80 per cent to pass, two attempts, and the certificate is issued automatically on a pass.

Five interactive tools. Optional, and deliberately excluded from the claimable CPD figure - if you complete them you may claim that time separately as self-directed CPD.

The category allocator is the core drill and the one you will repeat: a presentation, a category, and feedback that returns the descriptor's own words. The red flag spotter drills step 4 of the systematic approach on its own. Pressure at the desk rehearses the words for four situations in which you are asked to do something not clinically supported - every branch is survivable, because the point is the sentence, not the trap. The mental health triage drill exercises the combined-presentation rule. The scope self-check sorts every activity against your own role.

Three fillable instruments to take to work. These are the deliverables of the programme - the things that exist afterwards.

The triage audit tool audits twenty consecutive records against the published descriptors, plus documentation, distribution and the other three audits G24 names. The waiting room round record is P06's two requirements made into a piece of paper - a process, and a named person allocated to it. The triage competency and orientation record exists because this course satisfies part of one of G24's two conditions; it names the other three and ends with a departmental determination that OBA Nursing Academy does not make.

The reflective workbook - fillable, and your CPD evidence, which the NMBA expects you to hold alongside your certificate. The one-page scope of practice card, which is designed to be printed and kept where you work. And the further reading directory, with live links and a currency note.

Read the currency note. The G24 URL reads Jul-16 but the current document is V6 November 2023, and the P06 URL reads Jul-13-v04 but the current document is V5 November 2023. Check each document's own title page, not the address it is served from.