Emergency Severity Index (ESI): A Triage Tool for Emergency Department

Appendix B. ESI Triage Algorithm, v.4

Resources	Not Resources
Labs (blood, urine). ECG, X-rays. CT-MRI-ultrasound-angiography.	History & physical (including pelvic). Point-of-care testing.
IV fluids (hydration).	Saline or heplock.
IV or IM or nebulized medications.	PO medications. Tetanus immunization. Prescription refills.
Specialty consultation.	Phone call to PCP.
Simple procedure =1 (lac repair, foley cath). Complex procedure =2 (conscious sedation).	Simple wound care (dressings, recheck). Crutches, splints, slings.

D. Danger Zone Vital Signs. Consider uptriage to ESI 2 if any vital sign criterion is exceeded.

Pediatric Fever Considerations:

1 to 28 days of age: assign at least ESI 2 if temp >38.0 C (100.4F).
1-3 months of age: consider assigning ESI 2 if temp >38.0 C (100.4F).
3 months to 3 yrs of age: consider assigning ESI 3 if: temp >39.0 C (102.2 F), or incomplete immunizations, or no obvious source of fever.

©ESI Triage Research Team, 2004—(Refer to teaching materials for further clarification)

Page last reviewed October 2014

Internet Citation: Appendix B. ESI Triage Algorithm, v.4. October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/esi/esiappb.html