Triage is an essential element of providing care to patients who present at a hospital emergency department. Triage is defined as a brief clinical assessment that determines the time and sequence in which patients should be seen in the emergency department. During triage, an emergency department nurse interviews a patient or the patient's representative about the medical problem causing concern, makes a brief evaluation of the patient, and takes the patient's vital signs.

Based on the triage nurse's assessment, the patient will be assigned a priority of either emergent, urgent, semi-urgent, and non-urgent. Based on the priority assigned to the patient, the patient may be brought immediately into the emergency room for treatment or be asked to remain in the waiting room until it is his or her turn to receive medical evaluation and treatment. After a patient is triaged initially, it may be necessary for the triage nurse or other emergency department personnel to "re-triage" the patient to determine whether the patient's medical condition has deteriorated to the point where the patient needs to be seen sooner.

The failure to properly triage a patient who presents at a hospital emergency department can be the basis of a malpractice action. Because all hospitals are required to have triage protocols in place, a triage nurse is required to comply with the hospital's triage protocols. Failure to comply would be evidence of the nurse's negligence. A hospital's failure to have proper triage protocols can be the basis of liability for the hospital. Likewise, a hospital's failure to have supervisory procedures in place to monitor the triage process can be the basis of hospital liability.

Some common malpractice claims relating to the triage process are as follows:

• Triage personnel do not recognize high-risk complaints. Some common complaints that emergency room patients cite are signals of serious or life-threatening medical problems. For example, tightness in the chest and arm pain are common complaints signaling a possible cardiac arrest. Likewise, patients who complain of "the worst headache of their life" are possible aneurysm patients.
• Triage personnel do not address severe pain immediately. Studies have shown that emergency department patients who complain of severe pain usually have a serious medical problem. As such, triage workers must take these complaints seriously or risk allowing a very ill patient to suffer further deterioration.
• Triage personnel do not make proper documentation of the triage encounter. It is essential for triage personnel to record the triage encounter so that the nurses and physicians in the emergency room have access to the information.

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