Emergency nurse at admission in the emergency department

Abstract

The increasing number of patients referred to the emergency department highlights the importance of emergency triage by a dedicated nurse in charge of the organization at arrival (IOA). IOA’s expected expertise includes public relation, clinical, and organizational skills. IOA’s tasks consist in the initial evaluation, the decision of choosing the appropriate place of care, information of the patient and his accompanying persons as well as monitoring patient’s orientation. Triage requires appropriate working conditions and excellent collaboration between the medical and paramedical teams. A triage scale including evaluation and measurement of vital parameters is mandatory. The time required to contact the IOA, the delay to triage, and the percentage of under- and over-sorted patients represent indicators for quality. The IOA plays a major role in organizing the emergency department due to the regular increase in admissions. IOA’s task requires a prior one-year clinical experience in the emergency department, the provision of standardized tools, validated triage scales, reliable and reproducible protocols like screw pain, as well as additional tests like electrocardiogram. Training in the management of patient flows and violent situations represent major challenges. The 2004 guidelines of the French Society of Emergency Medicine detail the role and required qualifications for the job of IOA. Recommendations by experts are expected to be published soon.