Emergency Department Triage Manual, J-M

ED Triage Manual, J-M

Jaundice
Laceration
Limp
Mental Status, Altered

Jaundice

1 Critical	2 Acute	3 Urgent	4 Urgent	5 Non-Urgent
Jaundice with cardiopulmonary compromise or mental status change	Bili recheck New jaundice Concern for hemolysis Pallor Tachycardia Increased jaundice in pts with known liver, GI, hematologic disease TSB > 20 Jaundice in infant < 24 hrs old			Carotenemia
Consult MD/APP prior to initiating if: ESI 1, ill-appearing or requiring sepsis huddle Discharged from ED or CHOP within the past 24 hrs for a similar complaint

Laceration

1 Critical	2 Acute	3 Urgent	4 Urgent	5 Non-Urgent
Laceration with uncontrolled bleeding (unable to achieve hemostasis)	Absent perfusion to extremity Digit amputation Ocular complex/corneal laceration (inner eye, medial canthus, lash margin)	Complex lacerations involving mucus membranes or deeper tissues Laceration repair likely to warrant X-ray and/or sedation Anticipated need for specialty consult Nail bed injuries	Simple laceration repair not requiring subspecialty	Superficial abrasions Puncture wounds w/o FB (excluding animal bites)

Limp

Assess and document pain.
Administer acetaminophen/ibuprofen as per Standing Triage Order.
Make Level 1, 2, 3 patients NPO.

1 Critical	2 Acute	3 Urgent	4 Urgent	5 Non-Urgent
	Impaired distal neurovascular status Severe pain	PE evidence of fracture Significant swelling Deformity Focal tenderness Fever or history of fever with: Refusal to bear weight Significant limp Significant joint swelling or pain Tender erythema around a joint Mild limp Mild joint swelling without erythema or fever Point tenderness w/o deformity	Mild limp with known trauma, i.e., not infection	History of limp

Mental Status, Altered

1 Critical	2 Acute	3 Urgent	4 Urgent	5 Non-Urgent
	Confused, lethargic, disoriented New onset focal neurological deficits: Weakness of face, arm, leg Slurred speech Paralysis Loss/change in vision Loss of coordination/ataxia Think stroke

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

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