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ACEP 14: Triage-Leveling & ED Crowding

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The Particulars: Triage classification systems commonly assign five levels to patients. In these systems, level 1 and 2 patients are often given priority for ED bed assignment and level 4 and 5 patients are seen in designated locations. The throughput and utilization characteristics of level 3 patients remain unclear in comparison to patients with other triage levels.

Data Breakdown: A data analysis of more than 250 million ED visits was conducted, among which more than 100 million were for level 3 patients. Day of the week, time of arrival, and average pain scale level did not vary significantly between any triage level groups. However, level 3 patients had the longest wait times. Average length of visit times and visit proportions requiring tests or procedures were similar for level 1 through 3 patients and were significantly higher for level 4 and 5 patients.

Take Home Pearls: Triage level 3 patients appear to be more similar to level 1 and 2 patients than to level 4 and 5 patients with regard to length of stay and number of tests and procedures ordered. However, level 3 patients appear to have the longest wait times.

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