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Taipei City Hospital

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The Triage and Acuity Scale

       In the emergency department, immediate resuscitation is needed for cardiac arrest patients; fluid transfusion is needed for shocks, the causes of which then need to be found; hemostasis is key to stopping major bleeding; traumatic comas require stabilization of vital signs and injury determination. Only one chance is available for these patients to stabilize and survive their conditions, while for some conditions where the patient still has stable vital signs, their treatments can afford to wait a bit, such as those suffering from abdominal pain, flu and fever and mild injury.

       “The responsibility of the emergency department is to prioritize emergency conditions,” says Dr. Kuo Chung-tai, attending physician of the Department of Emergency Medicine at Taipei City Hospital’s Heping Fuyou Branch. The purpose of triage is to delineate the conditions of the patient, and to prioritize medical resources for patients with serious conditions.

       The Ministry of Health and Welfare has fully implemented the triage and acuity scale since 2010. The scale is classified into adults and children, and further grouped for 5 levels: Resuscitation, Emergent, Urgent, Less Urgent and Not Urgent. Reasonable times for diagnoses and possible waiting times in the clinic are also clearly defined:

Level 1: resuscitation (e.g. out of hospital cardiac arrest, unconscious), requiring immediate treatment.

Level 2: emergent (e.g. injury during car accident with stable vital signs), may wait up to 10 minutes.

Level 3: urgent (e.g. mild respiratory distress or pain), may wait up to 30 minutes.

Level 4: Less urgent, may wait up to 60 minutes.

Level 5: not urgent, may wait up to 120 minutes.

       The difference between emergency and outpatient clinic is that the priority is not based on order of registration. We ask everyone to respect these modes of emergency operation, and to give your support and trust to the medical staff responsible for injury triage. The system is built in place to ensure that everyone can receive the medical resources they need during urgent situations.