What Do You Know About Emergency Severity Index? Trivia Quiz

1. An example of an ESI level 1 patient is:

Chest pain with stable vital signs.

Right flank pain with significant guarding.

Child with barking cough and mild respiratory stridor but appropriate.

Elderly female with history of dementia with new mental changes.

Overdose patient with a respiratory rate of 6.

An ESI level 1 patient is someone who requires immediate life-saving intervention. In this case, the overdose patient with a respiratory rate of 6 is the correct answer because a respiratory rate of 6 is extremely low and indicates severe respiratory distress. This patient is in immediate danger and needs urgent medical attention to stabilize their breathing.

Explanation

An ESI level 1 patient is someone who requires immediate life-saving intervention. In this case, the overdose patient with a respiratory rate of 6 is the correct answer because a respiratory rate of 6 is extremely low and indicates severe respiratory distress. This patient is in immediate danger and needs urgent medical attention to stabilize their breathing.

2. Which of the following patients are NOT considered ESI level 2 patients?

Suicidal ideation.

Rash with no shortness of breath or stridor.

Dialysis patient after fistula placement that same day and having arm swelling.

Chest pain radiating to the left arm and into the back.

Witnessed syncopal episode.

The ESI (Emergency Severity Index) is a tool used to categorize patients based on their acuity level in the emergency department. ESI level 2 patients are considered to have high acuity and require immediate attention. In this case, all of the given patients have symptoms that are indicative of a potentially serious condition, except for the patient with a rash and no shortness of breath or stridor. While a rash can be uncomfortable, it is not typically considered a life-threatening or high acuity condition. Therefore, this patient would not be considered an ESI level 2 patient.

Explanation

The ESI (Emergency Severity Index) is a tool used to categorize patients based on their acuity level in the emergency department. ESI level 2 patients are considered to have high acuity and require immediate attention. In this case, all of the given patients have symptoms that are indicative of a potentially serious condition, except for the patient with a rash and no shortness of breath or stridor. While a rash can be uncomfortable, it is not typically considered a life-threatening or high acuity condition. Therefore, this patient would not be considered an ESI level 2 patient.

3. A person should be considered for a higher acuity rating if the patient presents how soon after their previous visit for the same complaint that is not resolved?

Within three days.

Within 24 hours.

Within 36 hours.

Within 2 days.

Within one week.

A person should be considered for a higher acuity rating if the patient presents within 24 hours after their previous visit for the same complaint that is not resolved. This indicates that the patient's condition has not improved within a short period of time, suggesting a potentially more serious or urgent issue that requires immediate attention.

Explanation

A person should be considered for a higher acuity rating if the patient presents within 24 hours after their previous visit for the same complaint that is not resolved. This indicates that the patient's condition has not improved within a short period of time, suggesting a potentially more serious or urgent issue that requires immediate attention.

4. How often should a patient be reassessed after the initial triage assessment?

Minimum of every 2 hours for ESI 3 or lower and as often as determined by the triage nurse.

Minimum of every 1 hour for ESI 5.

Minimum of every 7 hours for all levels.

As determined strictly by the triage nurse.

We do not reassess patients in this ER.

Patients should be reassessed after the initial triage assessment at least every 2 hours if they have an ESI level of 3 or lower. The frequency of reassessment should be determined by the triage nurse based on the patient's condition. This ensures that any changes in the patient's condition are promptly identified and appropriate interventions can be initiated.

Explanation

Patients should be reassessed after the initial triage assessment at least every 2 hours if they have an ESI level of 3 or lower. The frequency of reassessment should be determined by the triage nurse based on the patient's condition. This ensures that any changes in the patient's condition are promptly identified and appropriate interventions can be initiated.

5. What is a major issue as it relates to "frequent flyers" to the Emergency Department?

The tendency to anger the staff for consuming their time.

The possibility that a future visit may turn out to be an emergency need.

The increased amount of cost to the system.

The need to provide specialty consultation such as behavioral health.

One major issue for "frequent flyers" to the Emergency Department is the possibility that a future visit may turn out to be an emergency need. "Frequent flyers" are individuals who frequently visit the Emergency Department, often for non-emergency reasons. This can lead to a strain on resources and staff, as they have to allocate time and resources to these individuals, potentially taking away from patients with genuine emergency needs. Additionally, there is a concern that these frequent visits may indicate underlying health issues that could escalate into emergencies in the future.

Explanation

One major issue for "frequent flyers" to the Emergency Department is the possibility that a future visit may turn out to be an emergency need. "Frequent flyers" are individuals who frequently visit the Emergency Department, often for non-emergency reasons. This can lead to a strain on resources and staff, as they have to allocate time and resources to these individuals, potentially taking away from patients with genuine emergency needs. Additionally, there is a concern that these frequent visits may indicate underlying health issues that could escalate into emergencies in the future.

6. What is the correct response to a mother presenting to your triage window with a small child in her arms that appears: dusky with discolored nail beds, listless, and retractions?

Grab the child from mom and run immediately to a room.

Call the Flow Facilitator and attempt room placement.

Call the ER physician to request orders.

Shake the child to attempt to arouse the child.

The correct response to a mother presenting with a child who appears dusky, with discolored nail beds, listless, and retractions is to immediately push the "code" button on the wall and administer high flow oxygen via a large volume device while in the triage room. This is because the child is showing signs of respiratory distress, which could be life-threatening. Promptly activating the code button will alert the medical team to the emergency, and administering high flow oxygen will help improve the child's oxygenation.

Explanation

The correct response to a mother presenting with a child who appears dusky, with discolored nail beds, listless, and retractions is to immediately push the "code" button on the wall and administer high flow oxygen via a large volume device while in the triage room. This is because the child is showing signs of respiratory distress, which could be life-threatening. Promptly activating the code button will alert the medical team to the emergency, and administering high flow oxygen will help improve the child's oxygenation.

7. How often should the ESI algorithm me manipulated or changed to better the patient flow of the ER?

Every year.

Every six months.

Every 2 years.

Every 5 years.

The algorithm should never be changed or manipulated.

The given answer states that the ESI algorithm should never be changed or manipulated. This implies that the algorithm is designed to be effective and efficient in managing patient flow in the ER, and any changes or manipulations may disrupt its functioning. Therefore, it is recommended to maintain the algorithm as it is without any alterations.

Explanation

The given answer states that the ESI algorithm should never be changed or manipulated. This implies that the algorithm is designed to be effective and efficient in managing patient flow in the ER, and any changes or manipulations may disrupt its functioning. Therefore, it is recommended to maintain the algorithm as it is without any alterations.

8. Why are vital signs not utilized to determine ESI levels 4 or 5 in non-pediatric patients?

It is a variable that is not constant and unreliable even under the best conditions.

Vital sings are time consuming.

Vital signs can change the patient's complaint.

Vital signs can be manipulated by the patient.

Vital signs are not required by the ER MD.

Vital signs are not utilized to determine ESI levels 4 or 5 in non-pediatric patients because they are considered a variable that is not constant and unreliable even under the best conditions. This means that vital signs can fluctuate and may not accurately reflect the patient's condition. Additionally, vital signs can be time-consuming to measure and can be influenced or manipulated by the patient. Therefore, other factors and assessments are used to determine the ESI levels in these patients.

Explanation

Vital signs are not utilized to determine ESI levels 4 or 5 in non-pediatric patients because they are considered a variable that is not constant and unreliable even under the best conditions. This means that vital signs can fluctuate and may not accurately reflect the patient's condition. Additionally, vital signs can be time-consuming to measure and can be influenced or manipulated by the patient. Therefore, other factors and assessments are used to determine the ESI levels in these patients.

9. What question should a triage nurse ask themselves when deciding if a patient meets level 2 criteria?

How many resources will this patient need?

Would I give this patient my last available bed?

Is this patient dying?

What would my peers decide when in the same situation?

The question a triage nurse should ask themselves when deciding if a patient meets level 2 criteria is "Would I give this patient my last available bed?" This question helps the nurse assess the severity of the patient's condition and determine if they require immediate attention and resources. It also helps in prioritizing patients based on the availability of beds and resources, ensuring that the most critical patients receive timely care.

Explanation

The question a triage nurse should ask themselves when deciding if a patient meets level 2 criteria is "Would I give this patient my last available bed?" This question helps the nurse assess the severity of the patient's condition and determine if they require immediate attention and resources. It also helps in prioritizing patients based on the availability of beds and resources, ensuring that the most critical patients receive timely care.

10. According to the patient flow system of the Emergency Department, what is the accepted door to exam time for a level 4 patient?

Immediate.

10 minutes.

30 minutes.

60 minutes.

120 minutes.

According to the patient flow system of the Emergency Department, the accepted door to exam time for a level 4 patient is 60 minutes. This means that within an hour of the patient arriving at the emergency department, they should be examined by a healthcare professional.

Explanation

According to the patient flow system of the Emergency Department, the accepted door to exam time for a level 4 patient is 60 minutes. This means that within an hour of the patient arriving at the emergency department, they should be examined by a healthcare professional.

11. Which of the following is NOT a duty of the Flow Facilitator?

The discharging of patients.

Quick triage of incoming ambulance patients.

Patient placement from triage and EMS.

Quick evaluation of placement of already triaged patients.

Evaluation of acuities regarding already placed patients and workload for the staff.

The correct answer is "The discharging of patients." The other duties listed in the options are all responsibilities of a Flow Facilitator. The Flow Facilitator is responsible for quick triage of incoming ambulance patients, patient placement from triage and EMS, quick evaluation of placement of already triaged patients, and evaluation of acuities regarding already placed patients and workload for the staff. However, the discharging of patients is not mentioned as a duty of the Flow Facilitator.

Explanation

The correct answer is "The discharging of patients." The other duties listed in the options are all responsibilities of a Flow Facilitator. The Flow Facilitator is responsible for quick triage of incoming ambulance patients, patient placement from triage and EMS, quick evaluation of placement of already triaged patients, and evaluation of acuities regarding already placed patients and workload for the staff. However, the discharging of patients is not mentioned as a duty of the Flow Facilitator.

12. What information MUST be documented on the patient triage record for all pediatric patients?

Height, weight, temperature, pulse rate, respiratory rate, and oxygen saturation.

Height, weight, pulse rate, respiratory rate, oxygen saturation, and components of the pediatric triangle.

Height, weight, pulse, temperature, respiratory rate only.

The information that MUST be documented on the patient triage record for all pediatric patients includes height, weight, pulse rate, respiratory rate, oxygen saturation, and components of the pediatric triangle. This comprehensive set of data is necessary to assess the overall health and condition of pediatric patients and guide appropriate medical interventions. It allows healthcare providers to monitor vital signs, identify any abnormalities or distress, and make informed decisions regarding further treatment or care.

Explanation

The information that MUST be documented on the patient triage record for all pediatric patients includes height, weight, pulse rate, respiratory rate, oxygen saturation, and components of the pediatric triangle. This comprehensive set of data is necessary to assess the overall health and condition of pediatric patients and guide appropriate medical interventions. It allows healthcare providers to monitor vital signs, identify any abnormalities or distress, and make informed decisions regarding further treatment or care.

13. A focused Emergency Severity Index, Version 4 triage assessment should take how many minutes to complete and assign an acuity level?

9-10 minutes.

6-8 minutes.

4-5 mintues.

2-3 mintues.

Less than 1 minute.

A focused Emergency Severity Index, Version 4 triage assessment should take 2-3 minutes to complete and assign an acuity level. This time frame allows for a quick yet thorough evaluation of the patient's condition, ensuring that urgent cases are identified and prioritized appropriately. Completing the assessment within this time limit helps streamline the triage process and enables timely medical intervention for patients in need.

Explanation

A focused Emergency Severity Index, Version 4 triage assessment should take 2-3 minutes to complete and assign an acuity level. This time frame allows for a quick yet thorough evaluation of the patient's condition, ensuring that urgent cases are identified and prioritized appropriately. Completing the assessment within this time limit helps streamline the triage process and enables timely medical intervention for patients in need.

14. What are the three criteria that a presenting patient must meet (at least one of the three) in order to make the case an ESI level 2?

Severe pain, abnormal vital signs, intoxication

Abnormal vital signs, acute mental status changes, severe pain.

High risk situation, abnormal vital signs, severe pain.

High risk situation, acute mental status changes, severe pain.

Abnormal vital signs, severe pain, lethargic.

The three criteria that a presenting patient must meet in order to make the case an ESI level 2 are high risk situation, acute mental status changes, and severe pain. This means that the patient must be in a situation that poses a high risk to their health, they must have acute changes in their mental status, and they must be experiencing severe pain. These criteria help determine the urgency and severity of the patient's condition, warranting a higher level of care.

Explanation

The three criteria that a presenting patient must meet in order to make the case an ESI level 2 are high risk situation, acute mental status changes, and severe pain. This means that the patient must be in a situation that poses a high risk to their health, they must have acute changes in their mental status, and they must be experiencing severe pain. These criteria help determine the urgency and severity of the patient's condition, warranting a higher level of care.

15. What is the danger zone pulse rate for a patient in the 3-8 year-old range?

Greater than 120/min.

Greater than 130/min.

Greater than 140/min

Greater than 150/min.

Greater than 160/min.

The danger zone pulse rate for a patient in the 3-8 year-old range is greater than 140/min. This means that if a patient in this age range has a pulse rate higher than 140 beats per minute, it could indicate a potentially dangerous condition. It is important to monitor the pulse rate of young patients closely and seek medical attention if it exceeds this threshold.

Explanation

The danger zone pulse rate for a patient in the 3-8 year-old range is greater than 140/min. This means that if a patient in this age range has a pulse rate higher than 140 beats per minute, it could indicate a potentially dangerous condition. It is important to monitor the pulse rate of young patients closely and seek medical attention if it exceeds this threshold.

16. What is the determining temperature that would determine ESI 2 for a 27 day-old patient with a fever?

99.5 F

100.3 F

101.0 F

101.5 F

100.4 F

The determining temperature that would determine ESI 2 for a 27-day-old patient with a fever is 100.4 F. This means that if the patient's temperature is equal to or higher than 100.4 F, they would be classified as ESI 2, indicating a high priority level for medical attention.

Explanation

The determining temperature that would determine ESI 2 for a 27-day-old patient with a fever is 100.4 F. This means that if the patient's temperature is equal to or higher than 100.4 F, they would be classified as ESI 2, indicating a high priority level for medical attention.

17. A 10-day old infant is brought to the Emergency Department in triage to which the mother states she measured a fever of 101.9 F at home. The current temperature of the patient in the triage department is 99.0 F rectally. The patient is appropriate for age, sleeping but arousable, skin pink and dry, and the mucous membranes are moist. What ESI level are you going to assign to this patient?

ESI level 1

ESI level 2

ESI level 3

ESI level 4

ESI level 5

Based on the given information, the 10-day old infant has a fever of 99.0 F rectally, which is slightly lower than the mother's measurement of 101.9 F. The patient is appropriate for age, sleeping but arousable, and has normal skin and moist mucous membranes. ESI level 2 is assigned to patients who have a high probability of a significant illness or injury, but who are stable at the moment. Therefore, considering the infant's age and the slightly elevated temperature, ESI level 2 is the appropriate assignment for this patient.

Explanation

Based on the given information, the 10-day old infant has a fever of 99.0 F rectally, which is slightly lower than the mother's measurement of 101.9 F. The patient is appropriate for age, sleeping but arousable, and has normal skin and moist mucous membranes. ESI level 2 is assigned to patients who have a high probability of a significant illness or injury, but who are stable at the moment. Therefore, considering the infant's age and the slightly elevated temperature, ESI level 2 is the appropriate assignment for this patient.

18. What ESI level would a patient who is deemed a "P" on the AVPU scale?

ESI 1

ESI 2

ESI 3

ESI 4

ESI 5

A patient who is deemed a "P" on the AVPU scale is responsive to stimuli, indicating that they have a high level of consciousness. This suggests that their condition is potentially life-threatening or requires immediate medical intervention. According to the Emergency Severity Index (ESI), patients in this category are classified as ESI 1, which means they require immediate attention and should be seen by a healthcare provider within minutes.

Explanation

A patient who is deemed a "P" on the AVPU scale is responsive to stimuli, indicating that they have a high level of consciousness. This suggests that their condition is potentially life-threatening or requires immediate medical intervention. According to the Emergency Severity Index (ESI), patients in this category are classified as ESI 1, which means they require immediate attention and should be seen by a healthcare provider within minutes.

19. What ESI level should be considered for a 2 year-old child who presents with a measured temperature of 103.0 F, who is not current on their vacinations, and has no obvious cause for the fever?

ESI 1

ESI 2

ESI 3

ESI 4

ESI 5

According to the Emergency Severity Index (ESI) triage system, ESI level 3 is appropriate for a 2-year-old child who presents with a high fever (103.0 F) and has no obvious cause for the fever. ESI level 3 indicates that the patient requires urgent medical evaluation and treatment, but their condition is not immediately life-threatening. The child's lack of vaccinations may increase the risk of potential serious infections, which warrants prompt medical attention.

Explanation

According to the Emergency Severity Index (ESI) triage system, ESI level 3 is appropriate for a 2-year-old child who presents with a high fever (103.0 F) and has no obvious cause for the fever. ESI level 3 indicates that the patient requires urgent medical evaluation and treatment, but their condition is not immediately life-threatening. The child's lack of vaccinations may increase the risk of potential serious infections, which warrants prompt medical attention.