8. Triage Orientation Schedule

Canadian Paediatric Triage and Acuity Scale:
Implementation Guidelines for Emergency Departments

Triage orientation will vary in detail dependent on the triage nurses' paediatric knowledge, experience and skills. To accurately triage children it is essential to understand normal growth and development, the best approaches to children of different ages, and the changes that occur physiologically and emotionally from infancy to adolescence.

• Review roles and responsibility.
• Review paediatric physiologic parameters and the PAT.
• Review paediatric pain scales.
• Review family-centered care and history-taking through a third party.
• Review psychosocial issues and common presentations of child and spousal abuse.
• Documentation.
• Stocking room.
• Safety issues.

Step 1

• Cover triage for breaks.
• Identify 5 cases where you are unsure of your categorization and 5 cases you feel confident with your categorization. Follow them up and submit in writing to the nurse-clinician (with a copy of the patient's chart).
• When quiet in the department, inform the desk nurse and spend some buddy time in triage.
• Review the triage guidelines.

Golden rules for accurate triage

Step 2

• 4 hours of buddy time*

Step 3

• Review cases given
• 1­2 hours case review
• 2 hours buddy time per day*

Step 4

• Triage on own

Triage learning is an ongoing process. Providers should implement a system for case reviews. Triage nurses would assess patient presentations, triage decisions, and the rationale for the decisions made. These triage rounds should take place on a regular basis and be attended by the emergency multidisciplinary team members.

* Buddy time may be adjusted. In some instances one hour per day may be all that is required. In other instances more time may be required for nurses with little or no paediatric experience.