amzn-crt.gif (3625 bytes)
Click to buy from Amazon.com

Book Review:

 Emergency Nursing - 5-Tier Triage Protocols

Authors: Julie Briggs, RN BSN MHA & Valerie G. A. Grossman, BSN RN CEN
Publisher: Lippincott Williams & Wilkins
ISBN: 158255-371-8  
Reviewer: Tom Trimble, RN CEN

 
          The science of the art of triage is clearly organized and arrayed in this wire-bound handbook for a five-level acuity system, with an eye for consistency and compliance, in 86 protocols covering 120 conditions, and 20 appendices of reference material within 258 pages. In tabular form, it teaches discernment in assigning acuity levels by urgency, helps avoid missed questions, and provides room for notes. Training exercises and an assessment tool will help the preceptor develop critical thinking in the trainee.

           It is topically arranged alphabetically by "meat and potatoes" common complaints. This generic approach makes it a little awkward to look up problems by system, or to cluster them for teaching. Body Art Complications are included, but complications of patients with transplants or immune-deficiency problems, sickle-cell disease, cancer emergencies, or end-stage kidney or liver problems, or multi-system problems, for example, are not treated with a guide to assessment of those problems in context. This makes it more suited for community hospital problems or as a launch point for the mentored novice triage nurse, to systematically and repetitively use the structure to estimate how critical the patient is needing priority in care and his level of risk.  Some of this information can be found in appendices, thus "differential diagnosis of chest pain" includes transplant rejection and infection, yet cardiovascular aneurysm doesn't mention sudden onset or disproportionate pain but "differential diagnosis of abdominal pain" does for abdominal aortic aneurysm.

           Thus, strength and weakness (if that), are one. The focus is on quickly assessing severity. A quick-reference lie-flat-on-the-desk handbook will not and cannot bring all the data points and experienced judgment of a seasoned triage nurse with good clinical understanding to its pages. It is complaint-driven rather than diagnosis making. Method is key in this book with consistent application of "who needs help now; who can wait; how long can they wait in relation to their complaint." It is for the mentor or motivated self-learner to facilitate clinical correlation in reviewing each case encountered. Stronger cross-listing in the index would be useful: renal calculi are listed but not kidney stone or nephrolithiasis. Going to the Abdominal Pain protocol or the appendix will get you there, but think categorically.

            The authors not only encourage data gathering, they emphasize the qualities of personal interactions, courtesy and sensitivity, and consideration to upgrade triage category when history is hampered by youth, age, impairment of faculties, or language ability that might otherwise conceal potential problems. Psychiatric problems, abuse, intoxications, sexually-transmitted disease, foreign bodies, all find an approach within. Appropriate treatments to initiate at triage are indicated where needed. Always, reassessment of those who wait is recommended.

            This book puts forward a practical way of coming back to basics and helps categorize priority for patients. It does so in the format of the currently most-studied triage system type. As an educator or manager, I would feel confident that, with it, my nurses are being prepared to make safe decisions with an accurate program that reflects current thinking in triage strategy. As a book buyer, I would feel that I am getting full value for money for myself or my institution in using it as an aid to learning the triage decision-making process.
       


Date of Review: January 2006
Tom Trimble, RN CEN, is an experienced Emergency Nurse, Instructor, and the Editor & Publisher of this website. The opinions expressed are his own.
 

Disclosure: ENW! receives sample books for impartial review under its GUIDELINES. ENW! has no financial arrangements with publishers or authors. Where present, a purchase link is provided by ENW! as a convenience to its readers. The non-obligatory use of these links sometimes provides a small fee to ENW! (if from amazon.com) which provides no significant portion of operating costs for the website. ENW! is non-profit and dedicated solely to the interests of the Emergency Nursing specialty for which it is operated in trust. This page, as all others of the website, and the opinions of reviewers are subject to our DISCLAIMER.

 
 

Clinical Articles Special Articles

Links

2003 ASA
"Difficult Airway Practice Guidelines"

Airway 10 Commandments
Action Plan for Airway Hell!

Using Anesthesia Bags
Optimizing Mask Ventilation
Sedation Guidelines
Sedation Principles
Sedation Checklist

Aphorisms, Maxims, and Pearls
Discharge Instructions
I.V. Starts -Improving Your Odds!
Pediatric Hints -An ABC
Tips & Tricks -from Other Nurses
Manipulative Behaviors by Patients

Heat Emergencies
End Tidal CO2 Monitoring
in CPR: A Predictor of Outcome

Fix This Airway!
Crises in Airway Management

Bioterrorism References
Electrolytes
Headache & Stroke
Outsize Patients
--a big nursing challenge!

The Poisoned Patient
Respiratory Encounters (I Can't BREATHE! Part I)

Respiratory Encounters (I Can't BREATHE! Part II)

 

Internet Starter Set
Quick Subject Guide
Basic Desktop References
Medical Links
-  (Addiction Medicine to Gerontology)
Medical Links
- (Gov't to Medical Organizations)
Medical Links
- (Medical Records to Primary Care)
Medical Links
- [Psych. to Wilderness]
Nursing Links
[General]
Emergency Nursing Links
Pre-Hospital Links

- [Ambulance to EMS Web Pages]

Pre-Hospital Links
[Fire to Special Purpose Care Organizations]
Just for Fun Links
 
ENW !  urges help to
victims of recent disasters
American Red Cross  
donate page
 



supports and recommends

FREE EMERGENCY MEDICINE TALKS

   Emergency Medicine education for everyone.
 

MP3 files provided by: Joe Lex, MD
 


Fabulous Places!  --  Fabulous Conferences!
Check frequently for updates

   

Plan for the Year Ahead!  
Meetings & Symposia

                   Meetings of 2013

 
 
Clinical Research Behind the Scenes at ENW! The World of Emergency Nursing
Meet the Editor
Temperature Management
Gastric Decontamination

Thermometry in Acute Care
Latest Research in Resuscitation

Septic Children
ACT
INR
Carbon Monoxide
Malignant Hyperthermia
Geriatric Thermoregulation
SSRI's
"
Orthostatics"
NG Tubes
RSV
Defibrillation
Disclaimer  Applies to all portions of this site!

Policies of this Website

Information for Authors

The Emergency Nursing
& Emergency Nursing World ! FAQ


ENW is Listed@

What's This All About?

Tom Trimble's Tale
Library of Resources & Solutions
CPEN Review - Putting
 It All Together

Bedlam Among the Bedpans
Veinlite EMS
Body Piercing Removal Kit
& Training Program

Emergency Nursing 5-Tier
Triage Protocols
Emergency Newborn Care
Quick Reference to Triage
Quick-E Guides
The Emergency Nursing "Cool Web-Find!"
Honor Gallery of Previous Winners
An 1895 Look At Nursing
Beatitudes For Leaders
E-Mail Lists & Usenet Groups

Emergency Nursing WebLinks
Emergi-Lexicon
Em-Nsg-L: The Emergency Nursing List
Humor
Night-Shift Survival Tips
Old-Aid -Archaic & Obsolete
University-Level Emergency Nursing Education
Words & Thoughts
 
California ENA Website ENW! Supports ENA  

is now
http://www.CalENA.US

We Support

Use this button to
go to ENA's sit
e

Emergency
Nursing World !
is an independent entity and
NOT a component

of
ENA

 

 

 
Google


WWW ENW.org

Emergency

Nursing World !