The emergency room is a place where people are on the border between life and death or need urgent medical treatment. For example, In South Korea, there are about 4.5 emergency room doctors per one hundred thousand people and 14 beds per thousand residents. About 6,100,000 people go to the emergency room every year. This means that medical resources are limited, so it is not possible to treat all patients immediately. The emergency room is mainly focused on saving lives, not curing the sick. To manage the medical resources well and save more lives, triage kicks in (KOSIS, 2021a) (KOSIS, 2021b).
As mentioned earlier, triage was made to save more people’s lives. This is done by classifying the patients by the severity of the emergency. When the patient comes into the ER, the triage doctor will classify the patient’s level of urgency into four or more divided levels. This kind of level is determined by the location or currently available medical resources. For example, in South Korea, when the available medical resources are not extremely limited, they use a scale called KTAS, which means Korean Triage and Acuity Scale, and it is divided into five stages:
KTAS 1 is the level for those who are extremely vulnerable, such as having a heart attack or not breathing. They get continuous examinations and care from multiple doctors, and they get treatment simultaneously. These people are the first to get a diagnosis from a doctor, even if there is a long line. For a heart attack, the doctor will perform CPR on the patient and give them cardiac stimulants. For non-breathing patients, endotracheal intubation will be performed.
KTAS 2 is for those who have a potential danger to life, limb, or bodily function. The typical symptoms of this are myocardial infarction, cerebral hemorrhage, and cerebral infarction. This level needs fast treatment by the doctor, but not immediate.
The third level is KTAS 3, and this level is for those people who have a potential chance of being needed to get a treatment. At this level, the patient might need to wait more than an hour to meet a doctor.
The KTAS 4 is for a condition in which treatment or re-evaluation can be performed within 1-2 hours, considering the patient’s age, pain, or the possibility of deterioration or complications. At this level, depending on the hospital’s current available medical resources, the patient might wait for unlimited time.
Finally, KTAS 5 doesn’t need emergency medical treatment, so the hospital might even refuse hospitalization. This KTAS is based on the CTAS, which is made in Canada (Wikipedia contributors, 2022) (Caep, 2012).
In unusual cases, like a lack of medical resources or a mass casualty incident, the classification system differs. In such cases, the system will change to the original triage and classification method. The triage is divided into four groups. The first one is anyone who can walk, which is considered minor; the doctor will not give you any treatment unless the others are already treated. The next one is called delayed. This tag is for someone who needs a doctor’s treatment but is not immediately needed. Also, with more breathing but being unconscious or having abnormal breathing or perfusion. And finally, for someone who has a low chance of living even with doctors’ treatment, they are considered deceased. The reason they consider living people dead is because the medical resources used to give that kind of patient a small chance of living could save multiple lives. So, it could be seen as no mercy, but this system is used only in mass casualty incidents in which hundreds of people are dying and they will eventually die without the doctor’s help (Australian College for Emergency Medicine, 2018). First, anyone who can walk is considered minor; the doctor will not give you any treatment unless the others are already treated. Next is called delayed. This tag is for someone who needs a doctor’s treatment but is not immediately needed. Also, with more breathing but being unconscious or having abnormal breathing or perfusion. And finally, for someone who has a low chance of living even with doctors’ treatment, they are considered deceased. The reason they consider living people dead is because the medical resources used to give that kind of patient a small chance of living could save multiple lives. So, it could be seen as no mercy, but this system is used only in mass casualty incidents in which hundreds of people are dying and they will eventually die without the doctors’ help (Australian College for Emergency Medicine, 2018).
Reference
Australian College for Emergency Medicine (2018). ACEM – Triage. [online] acem.org.au. Available at: https://acem.org.au/Content-Sources/Advancing-Emergency-Medicine/Better-Outcomes-for-Patients/Triage [Accessed 24 June 2023].
Caep (2012). The Canadian Triage and Acuity Scale: Education Manual Module 1. [online] Available at: https://caep.ca/wp-content/uploads/2017/06/module_1_slides_v2.5_2012.pdf [Accessed 24 June 2023].
KOSIS (2021a). KOSIS. [online] kosis.kr. Available at: https://kosis.kr/statHtml/statHtml.do?orgId=411&tblId=DT_41104_432&conn_path=I2 [Accessed 24 June 2023].
KOSIS (2021b). KOSIS. [online] kosis.kr. Available at: https://kosis.kr/statHtml/statHtml.do?orgId=411&tblId=DT_41104_112&conn_path=I2 [Accessed 24 June 2023].
Torrey, T. (2022). What Medical Triage Is and How It Is Used to Priortize Treatment. [online] Verywell Health. Available at: https://www.verywellhealth.com/medical-triage-and-how-it-works-2615132 [Accessed 24 June 2023].
Wikipedia contributors (2022). Triage. [online] Wikipedia. Available at: https://en.m.wikipedia.org/wiki/Triage [Accessed 24 June 2023].
