For a severe injury or illness, go straight to the emergency triage desk, and do not queue at the registration window

The emergency department does not go by who arrived earlier. It sorts people into Level I through Level IV by how serious the condition is. The place that sets the level is the triage desk at the emergency entrance, not the registration window. When you arrive, report the most dangerous thing: heavy bleeding, not being able to get air, not being fully conscious, chest pain like a heart problem, or pain you cannot stand.

Cost

No money. Walk a few more steps inside the door to find the triage desk. Say the most dangerous symptom in a single sentence.

Benefit

The National Health Commission's 2024 edition of the emergency-medicine quality-control indicators says emergency triage must "sort patients into levels by how critical the condition is." "Level I is a critical emergency and needs treatment at once." "Level II is a severe emergency, and assessment and treatment often go on together." "Level III is an urgent case and needs to be seen within a short time." "Level IV is a non-urgent or less urgent case and is seen in order in the ordinary treatment area." Triage means that, on entering the emergency department, someone first rates how serious it is and sets the order of care. Beijing's implementation standard gives the response required at each level. Level 1: "assess and treat at once, and move the patient into the resuscitation room or the rescue room." Level 2: "monitor vital signs at once, start treatment within 10 minutes, and move the patient into the rescue room." Level 3: "treat ahead of level 4 patients, and have the patient wait in the ordinary treatment area; if the wait is longer than 30 minutes, assess again." Level 4: "seen in order, and the wait is long unless the condition changes; if the wait is longer than 4 hours, another assessment is allowed." In the Beijing standard, the manual rating indicators for level 1 include "acute disturbance of consciousness." Those for level 2 include "active or severe blood loss," "severe difficulty breathing," "chest pain that looks like a heart cause," and "severe pain from any cause (7 to 10 points)." Triage must "keep to the rule that critical and severe cases are seen first," and the entrance of the emergency department should have a triage area in a prominent place (the level standard is the national rule, and the response times are the Beijing standard).

Notes

Sorting into levels is the same across the country. How soon each level is handled is set by each province and city. This Beijing text is a version that can be checked word for word. The rating looks at heart rate, blood pressure, blood oxygen, and symptoms. Pain is among the items. Pain at 7 to 10 points can be rated level 2. The hard indicators for level 1 include the following. A heart rate above 180 beats a minute, or below 40 beats a minute. A systolic pressure below 70 mmHg. Systolic pressure is the higher reading in a blood-pressure pair. Blood oxygen below 80%. Shock, a definite myocardial infarction, or acute disturbance of consciousness. If you think triage set you too low, add the most dangerous symptom and say it clearly. If the condition changes while you wait, go back to the triage desk and get rated again at once. When it is truly critical, call 120 (see Section 13). Beijing's plan requires the pre-hospital emergency doctor to give a first rating by the standard, and for levels 1 and 2 to notify the emergency department of the receiving hospital in time so it can prepare to take the patient.

Sources · 2

1. 国家卫生健康委办公厅 (2024). 关于印发急诊医学等 6 个专业医疗质量控制指标（2024 年版）的通知（国卫办医政函〔2024〕150 号）附件 1，指标四「急诊分级分诊执行率」. gov.cn/zhengce/zhengceku/202405/content_69512…
2. 北京市卫生健康委员会 (2019). 北京市加强急诊预检分诊分级工作方案及附件《北京市医院急诊预检分诊分级标准（试行）》：「坚持急危重症优先就诊原则。按照患者病情的严重程度，遵循从重到轻、从病情迅速变化到相对稳定的原则，合理安排患者就诊顺序。」「在急诊科入口的显著位置，设置急诊预检分诊区域」「院前医疗急救医生应按照相关标准对患者进行初步分级，对1、2级患者需及时通知所送医院急诊科做好接诊准备」. wjw.beijing.gov.cn/zwgk_20040/ylws/201912/t20…