At any given moment, a veterinary hospital’s caseload – including number of patients and the severity of their conditions – can vary widely during pet emergencies. Veterinary teams use a process called “triage” to quickly determine the need of each patient who walks through the door seeking care.
The word “triage” comes from a French word meaning “to sort,” and that’s exactly the goal of this process. Triage prioritizes patients with the most severe and timely medical needs, so they can receive prompt care when seconds count.
Triage is one of the main factors that impact wait time during visits to the emergency vet hospital.
What happens during the triage process?
Triage is performed by a veterinary technician or veterinarian. They briefly assess your pet in order to determine the medical priority. During your pet’s triage, the team is looking for the following indicators of medical urgency:
General appearance
Your pet will be assessed for obvious signs of injury or illness, like broken bones, bleeding or major wounds.
Respiratory signs
Your pet’s breathing gives insight into their overall health status, so the triage team will look for signs of labored or rapid breathing, difficulty getting air and the presence of coughing.
Alertness
They will assess your pet’s overall level of alertness. Generally, brightness and responsiveness are good signs, whereas a dull or unresponsive appearance may indicate trouble.
Vital signs
Your pet’s temperature, heart rate and respiratory rate may be recorded. If the triage team suspects a severe or complex concern, they may want to also check blood pressure.
Brief history about your pet’s condition
Be prepared to answer the question, “What happened?” Your pet’s care team will need to know what brought you to the ER, and general information about your pet, such as prior medical history and current medications. They may ask follow-up questions to help better determine how critical your pet’s situation is.
Triage is not intended to diagnose or treat your pet at that specific moment. During that time, the team gathers basic information to determine your pet’s level of medical urgency. Later on in the process, your pet will have an in-depth exam, where you can have a deeper discussion about your pet’s condition with a veterinarian.
While the process usually begins with an initial conversation with you, it’s important to know that triage often happens in the back exam area in the presence of the medical team only. Don’t be surprised if your pet is briefly whisked away for triage upon arrival at the hospital. They’re in good hands.
Your pet’s triage status could change after their initial assessment. For example, if your pet arrives in stable condition, then begins experiencing life-threatening symptoms while waiting to see the doctor, your triage status will be escalated so you can receive faster care. Keep an eye on your pet during your wait and let the team know if there are any changes in your pet’s condition.
What are the levels of triage in vet hospitals?
Behind the scenes at the emergency vet hospital, all triaged patients are prioritized into care categories based on the information from their initial assessments. While each hospital has its own naming or numbering conventions for triage categories, they all generally fall into these areas of urgency:
Level 1: Requires immediate and lifesaving care
Level one patients have the most severe and time-sensitive cases and they receive prompt care. These are emergencies where time is of the essence and the team has to act very quickly to save their lives and stabilize their health.
Level 1 emergencies include:
- Poisoning or ingestion of a toxic substance
- Severe allergic reactions
- Heatstroke or hypothermia
- Bloat (also known as “GDV” in dogs)
- Severe or frequent seizures
- Severely broken or protruding bones
- Trauma like hit-by-car accidents or animal attacks
- Severe head and neck wounds
- Excessive or uncontrollable bleeding
- Breathing problems like choking and trouble getting air
- Inability to urinate
Level 2: Urgent with possible wait times
Level two patients need medical help but they’re not facing immediate risks.
These are urgent concerns like:
- Frequent or severe vomiting or diarrhea
- Closed fractures
- Blood in urine
- Straining to urinate
- Eye injury
- Lameness (non-weight-bearing)
- Coughing
Level 3: Stable cases with probable wait times
Level three patients have illnesses or injuries that are stable and can wait to seek care without risking complications.
Common level three concerns include:
- Abscesses
- Skin lesions
- Minor wounds and lacerations
- Sneezing or nasal discharge
- Lameness (weight-bearing)
- Chronic disease
- Broken nails
- Visible masses
- Full anal glands
- Fleas or ticks
- Intestinal parasites
In many cases, level three concerns can be treated by veterinary urgent care clinics or even your family veterinarian, so you may have options of where to get care depending on their hours of operation. If you aren't sure, don't hesitate to call either location for guidance.
What determines ER wait times?
Due to the nature of emergency medicine, wait times at BluePearl hospitals can change instantaneously based on the severity of other emergencies in our care.
Whether you wait for two minutes or two hours, please keep a few key points in mind:
- Your pet’s team is working as efficiently as possible.
- We understand your worry, and we care about your pet. We’re pet owners too, and we know how scary it is to see your pet experience a medical emergency.
- There are often many more patients in the hospital than initially meets the eye.
If you’re waiting in an empty lobby, you might not see the many patients in the back being treated for highly critical emergencies.
If another pet arrives and immediately receives care while you’re still waiting, know that pet needs life-saving care so they can return home to their families.
If the parking lot looks empty and there’s a wait time, that may be because there was a big wave of drop-off patients brought in an hour earlier.
Because your pet’s wait time is largely a result of their triage status and the triage statuses of all the other pets awaiting and receiving care, your wait time may fluctuate and become shorter or longer throughout the duration of your visit.
If you have questions about your pet’s wait time, ask the team members so they can provide you with a status update or help provide more clear information about what to expect next.
My pet has been triaged – now what?
Based on your pet’s assessment, there are generally two scenarios that happen immediately after triage:
- If your pet needs immediate medical care, a veterinarian will immediately begin stabilization measures, such as supplying oxygen or IV fluids.
- If your pet needs care urgently but not immediately, you’ll be directed to wait either in the lobby or an exam room with your pet.
Either way, the emergency staff will communicate the expectations for what happens next.
Looking ahead: Next steps in the care process
Triage is the first step of your emergency visit. Here are the usual next steps following your pet’s initial assessment:
Exam
Performed by a veterinarian, your pet’s exam is a more in-depth evaluation of their condition. Your pet’s ER vet will ask you questions, provide diagnostic and treatment recommendations and give you a cost estimate. You’re an essential part of your pet’s care, and we encourage you to ask questions at this time.
Diagnostics
Depending on your pet’s reason for visiting, the vet may recommend diagnostic tests like bloodwork, x-rays or advanced imaging.
Treatment
Your pet can begin treatment to help them feel better and heal their injury or illness. Common treatment options in the ER include medications, IV fluids, oxygen therapy, wound management, surgery and more.
Continued care or hospitalization
Once your pet is stable and no longer in an emergency-level situation, they will likely be discharged with instructions for home care or a possible follow up with your family veterinarian.
If your pet’s condition is severe and they’re not stabilized quickly, they may require a hospital stay that can range from overnight to several days or, rarely, weeks. If your pet is diagnosed with a chronic or complex illness, you may be referred to a veterinary specialist within the same hospital or at a separate location.
