Triaging The Ocular Emergency Mark A. Yoder, O.D. 107 N. Main Street PO Box 123 Bluffton, OH 45817 What Is TRIAGE? TRIAGE Email: myoder@wcoil.com @yoderod What Is An EMERGENCY? triage trēˈäzh (noun) (in medical use) the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties. T Take The Call! emergency iˈmərjənsē/ (noun) a serious, unexpected, and often dangerous situation requiring immediate action. French sorting, sifting from trier to sort Don t Let Them Get A Busy Signal! Don t Make Them Wait (How Many Rings?) How Do You Answer The Phone? Don t Put An Emergency On Hold! Make Sure You Know Who The Patient Is. Has The Patient Been Seen By You Before? Has The Patient Been Seen For This Problem Before? 1
R RELAX! Church Bulletin Bloopers The Rev. Adams spoke briefly, much to the delight of his audience. Weight Watchers will meet at 7:00 pm. Please use the double door at the side entrance. Don t let worry kill you let the Church help. For those of you who have children and don t know it, we have a nursery downstairs. This afternoon there will be a meeting in the south and north ends of the church. Children will be baptised at both ends. Next Sunday a special collection will be taken to defray the cost of the new carpet. All those wishing to do something on the new carpet will come forward and do so. Listen closely to what the patient is telling you. What they say is not always what they mean. WHAT? WHERE? WHEN? WHY? HOW? What is the age of the patient? Which eye is effected? Does the patient wear contact lenses? What type of medications is the patient on? Is there trauma involved? Is there a history of allergies? BE CALM The more nervous you are, the more nervous the patient will be. BE COOL Make the caller feel like their problem is your total focus. BE COLLECTED Keep in mind the things you need to do to help this patient. Understand that the person on the other end of the line is under a lot of stress. They may not treat you in the manner that you wish to be treated. Be kind! Church Bulletin Bloopers A bean supper will be held on Tuesday evening in the church hall. Music will follow. At the evening service tonight, the sermon topic will be What Is Hell? Come early and listen to our choir practice. Pastor is on vacation. Massages can be given to the church secretary. The peacemaking meeting scheduled for today has been canceled due to a conflict. Ladies, don't forget the rummage sale. It is a good chance to get rid of those things not worth keeping around the house. Bring your husbands. The Associate Minister unveiled the church's new tithing campaign slogan last Sunday: "I Upped My Pledge - Up Yours." A Ask How Often? (frequency) I Identify The Problem Some recurrent problems will make you less alarmed! Some recurrent problems will make you more alarmed! Has the patient had surgery recently? 2
G Get An Idea Of How Bad The Problem Bothers Them How long has this been going on? How long ago did you first notice it? Have you seen us before regarding a similar problem? Have you seen anyone else before regarding a similar problem? Doc, I ve lost vision out of ONE EYE! Ouch Ouch Ouch YOOOWWWW! Fix it soon. Fix it quick. FIX IT NOW! Things You Can Laugh About E Extent (Duration) 3
Things That Can Wait Contact Lens Problems EMERGENCY? Doc, I ve lost vision out of ONE EYE! Contact Problems Out Of Solution Forgot My Appointment Didn t Have Time Your Hours Aren t Convenient Enough For Me Etc. Things That Can t Wait Long Within Days 4
Old Retinal Detatchment Optic Neuritis Ocular Tumors 5
Diabetic Changes Protrusion Of An Eye Things That Can t Wait Long Same Day Undiagnosed Glaucoma Dramatic Rx Changes Doc, I ve lost vision out of ONE EYE! 6
Acute Narrow Angle Glaucoma Corneal Foreign Body Corneal Ulcer 7
Corneal Abrasion Acute Iritis 8
Retinal Detatchment Trauma 9
Surgical Problems Hyphema Lid Laceration 10
Sudden Onset Of Double Vision Or Droopy Lid Chemical Burns Penetrating Injuries Things That Can t Wait AT ALL! 11
Central Retinal Artery Occlusion Doc, I ve lost vision out of ONE EYE! 12
and I have a TERRIBLE headache! Temporal Arteritis Sudden Loss Of Vision Doc, I ve lost vision out of ONE EYE! 13
Doc, I ve lost vision out of ONE EYE! Thanks For Hanging Out With Me Today! Mark A. Yoder, O.D. 107 N. Main Street PO Box 123 Bluffton, OH 45817 Email: myoder@wcoil.com @yoderod Write down one thing you learned in this session. Take it back and share it with the clinic you work in! 14