Triage & Treatment Rooms

When a patient arrives at the AMC Emergency Room (ER) the first stop is usually with a Triage Nurse, a registered nurse who has been specially trained to perform a quick assessment of the seriousness of injury or illness.
The patient or accompanying person will be asked why he came to the ER, what medical problems he is experiencing, what medications he is currently taking and if he is allergic to any medications. The nurse will also record a brief medical history. The patient’s vital signs will be taken and - temperature, heart rate, blood pressure, respiration, pulse oximeter which indirectly measures the oxygen saturation of a patient'sblood and, when indicated, weight.
After the assessment the patient is assigned a triage category according to which patients are assigned treatment priority.
There are five triage categories:

• Triage category 1: need for resuscitation - patients seen immediately. People in this group are critically ill and require immediate attention. Most arrive at the emergency department by ambulance. This group includes people whose heart may have stopped beating, whose blood pressure may have dropped to dangerously low levels, who may be barely breathing or have stopped breathing, who may have suffered a critical injury or who may have had an overdose of intravenous drugs and be unresponsive.
• Triage category 2: emergency - patients seen within 10 minutes. People in this group will probably be suffering a critical illness or very severe pain. For example, the group includes people with serious chest pain likely to be related to a heart attack, people with difficulty breathing and people with severe fractures.
• Triage category 3: urgent - patients seen within 30 minutes. People in this group include patients suffering from severe illnesses, people with head injuries but who are conscious, and people with major bleeding from cuts, major fractures, persistent vomiting or dehydration.
• Triage category 4: semi-urgent - patients seen within 60 minutes. People in this group usually have less severe symptoms or injuries, although the condition may be potentially serious. Examples include people with mild bleeding, a foreign body in the eye, a head injury (but where the patient never lost consciousness), a sprained ankle, possible bone fractures, abdominal pain, migraine or earache.
• Triage category 5: non-urgent - patients seen within 120 minutes. People in this group usually have minor illnesses or symptoms that may have been present for more than a week, like rashes or minor aches and pains. The group includes people with stable chronic conditions who are experiencing minor symptoms.

After first medical assessment, the patient may be assigned to one of the other ER areas. If for example a bone is broken and no surgery is required, the patient will be transferred to the cast room. Or if stitching of a deep wound is indicated, the on-call plastic surgeon will be contacted to meet the patient in the acute treatment room. If a patient shows symptoms of acute constipation then he will be wheeled into the enema room for immediate treatment.

It should be stressed that the emergency room will include a section constructed as a protective shelter against conventional, biological and chemical weapons, conforming to the latest requirements of the Israeli Home Front Command thus enabling emergency staff to continue caring for patients regardless of the external security threats. The need for this was forcefully demonstrated during Operation Cast Lead as rockets rained down upon the Ashdod Medical Center catchment area.