Triage Berbasis Bukti
Triage Berbasis Bukti
LATAR BELAKANG
IGD pintu pertama pemberian pelayanan terhadap cedera
mayor dan kondisi kegawatan yang mengancam nyawa
Sistem manajemen
pasien gawat darurat
TRIAGE
Apa itu Triage?
NO
DIAGNOSIS
Sistem triage yang efektif dan efisien
1. Mengurangi kepadatan IGD
2. Mengurangi waktu tunggu pasien
3. Meningkatkan pengkajian pasien
4. Meningkatkan patient flow
5. Meningkatkan kepuasan pasien
6. Meningkatkan patient outcomes
7. Meningkatkan patient safety
8. Mengontrol infeksi
(Augustyn, Ehlers, & Hattingh, 2009; Bruijns, et al., 2008;
Chan & Chau, 2005; Coughlan & Corry, 2007; Göransson
& von Rosen, 2010; Woolwich, 2000)
TUNTUTAN AKREDITASI
• Standar akreditasi SNARS 2018, STANDAR
PELAYANAN BERFOKUS PASIEN (AKSES KE RUMAH SAKIT
DAN KONTINUITAS PELAYANAN)
Elemen penilaian ARK 1.1
Triage berbasis bukti, Pelaksanaan, staf terlatih
menggunakan kriteria, pasien dengan kebutuhan mendesak
diprioritaskan.
• Standar JCI
Access to Care and Continuity of Care Priority assessment
and treatment for emergent and urgent patients
INTERNATIONAL LITERATURE
TRIAGE SYSTEM
LEBIH
DIREKOMENDASIKAN
5-LEVEL TRIAGE SYSTEM
17 / 19
Category Criteria Color
1 Emergency or life-threatening condition Red
requiring emergent care
2 Less serious condition requiring Yellow
emergent care
3 Non emergency condition and can wait Green
for treatment
4 Dead Black
Ministry of Health The Republic of Indonesia (1999)
START Adult Triage
Able to walk ? Yes
MINOR Secondary Triage
No
No Spontaneous
Spontaneous
Position airway IMMEDIATE
breathing
breathing
APNEA
EXPECTANT
Triage Categories
Yes
No
No
Spontaneous breathing Spontaneous
Position airway IMMEDIATE
breathing
APNEA
Palpable pulse? No
EXPECTANT
APNEA
Yes 5 rescue breaths EXPECTANT
Spontaneous breathing
Triage Categories
IMMEDIATE
EXPECTANT Black Triage Tag Color
• Victim unlikely to survive given severity of injuries, level of
available care, or both
• Palliative care and pain relief should be provided
< 15 or > 45
Respiratory Rate IMMEDIATE
IMMEDIATE Red Triage Tag Color
• Victim can be helped by immediate intervention and transport
• Requires medical attention within minutes for survival (up to 60)
• Includes compromises to patient’s Airway, Breathing, Circulation.
15 - 45
Palpable Pulse? No
IMMEDIATE DELAYED Yellow Triage Tag Color
• Victim’s transport can be delayed
• Includes serious and potentially life-threatening injuries, but status
not expected to deteriorate significantly over several hours.
Yes
MINOR Green Triage Tag Color
Inappropriate “P”
• Victim with relatively minor injuries
Neurological (e.g.,posturing) or “U” • Status unlikely to deteriorate over days
IMMEDIATE
Assessment • May be able to assist in own care : “Walking Wounded”
(AVPU)