Initial assessment and triage in ER.

Triage refers to quick assessment of a patient in the Emergency Room with a view to define urgency of care and priorities in management. Triage evaluation can be completed in an organized and systematic manner using Pediatric Assessment Triangle (PAT), which refers to immediate visual and auditory assessment of appearance, breathing and circulation. At the end of PAT, patient's illness is categorized as either stable or unstable. Unstable conditions are further classified into life threatening and non life threatening. Patients in the former category include those in need of immediate resuscitation e.g. cardiac arrest, cardio-respiratory failure, decompensated shock, deep coma, severe stridor etc. Once a child is on the way to stabilization, the primary assessment (assessment pentagon),which takes 1-3 min follows. It involves the detailed physical examination/assessment of airway (A), breathing (B), circulation(C), neurologic abnormalities (D) and head to- toe examination (Exposure). After the primary assessment, patient's illness severity is triaged into 5 levels of acuity based on the physiological abnormalities: those in need of Resuscitation, Emergent care, Urgent care, Less urgent and Non-urgent care.