Reviewed and approved by the AAEM Board of Directors. (June 5, 2020)
Recommendations:
1) Triage nurse-ordered testing reduces Emergency Department length of stay, though the overall
decrease in time is small. The decision to utilize triage nurse-ordered testing should weigh the
potential time saved versus the risk of extraneous testing.
2) Limited data suggests that triage nurse-ordered testing is reasonably accurate for the ordering
of limb x-rays, though less accurate for labs. If utilized, it is important to ensure sufficient
training, education, and oversight.
Introduction:
Emergency Departments (ED) provide critical access to the health care system and are essential to the early identification of epidemics and disease trends, stabilization of critically ill or injured patients, and careof the under-resourced and uninsured. In 2016, EDs in the United States treated over 145 million patients,1 representing a steadily increasing number of annual visits when compared with the previous 10-year period.2 Emergency Medicine has been the safety net for American healthcare for decades, providing services 24 hours per day and 365 days per year, without regard for patients’ social or economic status. Despite the steady increase in ED visits, available resources have decreased. Hospitals are increasingly being closed, with more than 10% of hospitals shutting down over the past two decades.3-5 Moreover, the number of available inpatient beds in the United States has declined from 1.5 million in 1975 to 924,000 in 2020.3-5