Rapid triage performed by nurses: Signs and symptoms associated with identifying critically ill patients in the emergency department.

Aim: Aim of this study is to identify signs and symptoms associated with identifying critically ill patients by rapid triage assessment performed by nurses in an emergency department. Background: In some emergency services, the immediate assessment of critically ill patients occurs before opening the hospital formal registration and it is based on the nurse's experience. Studies on the topic are essential to improve this process. Design This is a cross‐sectional, quantitative study. Methods: This study was conducted in a Brazilian emergency department in 2017. Adult patients who presented potentially life‐threatening symptoms underwent rapid triage to determine the medical urgency. Those identified as being critically ill were classified as high priority and streamed to the emergency room. Results: A total of 154 (84.6%) patients were classified as high priority from the total of 182 evaluations. Altered state of consciousness (35.2%) and altered skin perfusion (25.3%) were frequently identified. Signs and symptoms associated with identifying critically ill patients by rapid triage were alterations in ventilation (OR 6.09; p = 0.028), neurological dysfunction (OR 44.96; p < 0.001) and pain (OR 5.80; p = 0.004). Conclusion: Nurses should value neurological and ventilation alterations and pain in patients during rapid triage, since these signs and symptoms are associated with high care priority. Summary statement: What is already known about this topic? Research carried out in different countries highlights the importance of triage and risk classification systems, especially in the context of overcrowding in the emergency department.The time that a critically ill patient waits to receive effective treatment is one of the most significant predictors of unsatisfactory clinical outcomes.There are very few studies which have utilized a simple quick‐look method of triage in relation to other studies which commonly used a five‐level triage system in the emergency department. What this paper adds? In this study, we analysed the rapid triage performed by emergency nurses of patients' self‐reporting severe complaints in the emergency department.The results showed that some signs and symptoms identified by nurses during the rapid triage were associated with identifying critically ill patients in the emergency department.Knowing characteristics of rapid triage is essential to direct strategies for improvement in the early and safe identification of critically ill patients who seek care in the emergency service, enhancing the chances of survival. The implications of this paper for practice: Emergency nurses must remain vigilant for acute alterations in patient neurological, respiratory and pain status, as these may potentially herald critical illness and poor patient outcomes.Early detection of patients with critically illness optimizes utilization of finite resources and stabilizes care flows. [ABSTRACT FROM AUTHOR]