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

Version 4

The Emergency Severity Index (ESI) is a five-level emergency department (ED) triage algorithm that provides clinically relevant stratification of patients into five groups from 1 (most urgent) to 5 (least urgent) on the basis of acuity and resource needs. The Agency for Healthcare Research and Quality (AHRQ) funded initial work on the ESI.

Copyright Notice

ESI Algorithm

ESI Triage Algorithm v. 4 card (PDF, 142 KB)
ESI Triage Algorithm v.4 poster (PDF, 45 KB)

ESI Training Materials

The ESI materials, including four recorded lectures, 26 practice case videos, and an implementation handbook, are essential resources for ensuring that your emergency department staff are well trained in using ESI. The materials were previously available on DVD, so users who already have the DVD set do not need to replace any files. Users who got the DVD set before the handbook was updated in 2012 may want to download the newer version.

Instructions for Using Training Materials
Emergency Severity Index Implementation Handbook, 2012 Edition (PDF File, 1.3 MB): The Implementation Handbook discusses the ESI and the research behind it. The handbook also includes information on:
- Pediatric triage.
- Frequently asked questions.
- Additional practice cases.
- Full-page and pocket-sized versions of the ESI Version 4 Algorithm that emergency department personnel can cut out and refer to as needed.
Handbook Author Biographies

Where To Obtain Additional Information

For ESI Version 4 algorithm content and research-related questions, please email esitriage@yahoo.com. For information about ESI training, go to http://www.esitriage.org/

For more information about the AHRQ program that supported the development of these products, please email lisa.krever@ahrq.hhs.gov.

Practice Cases

Videos of the 26 practice cases are available on YouTube:

Pediatric Sprained Ankle - also includes introductory information
Respiratory Distress
Lump on Back
Lower Abdominal Pain With Vaginal Bleeding
Urinary Retention
Dislocated Shoulder
Cellulitis
Elderly Patient With Pneumonia
Laceration
Hematemesis
Headache
Infected Wound
Alcoholic With Head Injury
Weak Male With Chronic Renal Failure
Pediatric Trauma
Hypertension
Post Arrest
Poison Ivy
Possible Myocardial Infarction
Epigastric Area Pressure
Suicidal Ideation
Weak and Dizzy
Pediatric Fever
Asthmatic Teen
Urinary Tract Infection
Conjunctivitis

Page last reviewed May 2018
Page originally created September 2012

Internet Citation: Emergency Severity Index (ESI): A Triage Tool for Emergency Departments. Content last reviewed May 2018. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/esi/index.html