|
ATS category |
Response |
Description of category |
Clinical descriptors (indicative only) |
Category 1 |
Immediate Simultaneous Assessment and treatment |
Immediately life threatening Conditions that are threats to life (or imminent risk of deterioration) and require immediate aggressive intervention |
Cardiac arrest Respiratory arrest Immediate risk to airway -impending arrest Respiratory rate < 10/min Extreme respiratory distress BP<80 (adult) or severely shocked child / infant Unresponsive or respond to pain only (GCS <9) Ongoing / prolonged seizure IV overdose and unresponsive or hypoventilation Severe behavioral disorder with immediate threat of dangerous violence |
ATS category |
Response |
Description of category |
Clinical descriptors (Indicative only) |
Category 2 |
Assessment and treatment Within 10 minutes (assessment and treatment often simultaneous) |
Immediately life threatening The patient’s condition of serious enough or deteriorating so rapidly that there is the potential of threat to life, or organ system failure, if not treated within 10 minutes of their arrival Or Important time – critical treatment The potential for time-critical treatment (e.g. thrombolysis, antidote) to make a significant effect on clinical outcome depends on treatment commencing within a few minutes of the patient’s arrival in the ECC Or Very severe pain Humane practice mandates the relief of very severe pain or distress within 10 minutes of the patients arrival |
Airway risk – severe strider or drooling with distress Severe respiratory distress Circulatory compromise clammy or mottled skin poor perfusion HR < 50 or 150 (adult) Hypotension with haemodynamic effects Severe blood loss Chest pain of likely cardiac nature Very severe pain – any cause BSL < 2 mmol/ L (ambulance) Drowsy, decreased responsiveness – any cause (GCS <13) Acute hemiparesis / dysphasis Fever with signs of lethargy – any age Acid or alkali splash to eyes – requiring irrigation Major multi trauma ( requiring rapid organized team response) Severe localized trauma – major fracture, amputation High risk history Significant sedative toxic ingestation Severe pain suggestion. PE, AAA Ectopic pregnancy Behavioural / psychiatric Violent or aggressive Immediate threat to self or others Requires or has restraint Severe agitation |
ATS category |
Response |
Description of category |
Clinical descriptors (Indicative only) |
Category 3 |
Assessment and treatment Within 30 minutes |
Potentially life threatening The patient’s condition may progress to life or limb threatening, or may lead to significant morbidity, if assessment and treatment are not commenced within thirty minutes of arrival Or Situational urgency There is potential for adverse outcome if time critical treatment is not commenced within 30 minutes Or Humane practice mandates the relief of very severe discomfort or distress within 30 minutes |
Severe hypertension Moderately severe blood loss – any cause Moderate shortness of breath Oxygen saturation 90-95% Seizure (now alert) BSL >15 mmol/ L Any fever if immunosupressed, e.g. oncology patient, steroid treatment Persistent vomiting Dehydration Head injury with short LOC – now alert Moderately severe pain – any cause – requiring analgesia Chest pain likely non-cardiac and moderately severe Abdominal pain without high risk features – mod to severe or pt >65 years Trauma – high risk hx with no other high risk features Child at risk Behavioural / psychiatric Very distressed, risk of self harm Acutely psychotic or thought disordered Situational crisis, deliberate self harm Agitated / withdrawn Potentially aggressive |
ATS category |
Response |
Description of category |
Clinical descriptors (Indicative only) |
Category 4 |
Assessment and treatment Within 60 minutes |
Potentially serious The patient’s condition may deteriorate, or adverse outcome may result, if assessment and treatment is not commenced within one hour of arrival in ECC. Symptoms moderate or prolonged. Or Situational urgency There is potential for adverse outcome if time critical treatment is not commenced within one hour. Or Significant complexity or severity Likely to require complex work up and consultation and / or impatient management Or Humane practice mandates the relief of discomfort or distress within 1 hour |
Mild haemorrhage Foreign body aspiration, no respiratory distress Chest injury without rib pain or respiratory distress Minor head injury, no loss of consciousness Moderate pain, some risk features Vomit or diarrhoea without dehydration Eve inflammation or foreign body - Normal visual acuity Minor limb trauma – sprained ankle, possible fracture, uncomplicated laceration requiring investigation or intervention – normal vital signs – Low / moderate pain Tight case, no neurovascular impairment Swollen ‘hot’ joint Non-specific abdominal pain Behavioural / psychiatric Semi urgent mental health problem Under observation and or no immediate risk to self or others |
ATS category |
Response |
Description of category |
Clinical descriptors (Indicative only) |
Category 5 |
Assessment and treatment Within 120 minutes |
Less urgent The patient’s condition is chronic or minor enough that symptoms or clinical outcome will not be significantly affected if assessment and treatment are delayed up to two hours from arrival Or Chronic – administrative problems Results review, medical certificates |
Minimal pain with no high risk features Low risk hx and now asymptomatic Minor symptoms of existing stable illness Minor symptoms of low risk conditions Minor wounds – small abrasions, Minor lacerations (not requiring suturing) Scheduled revisit. E.g wound or fracture review Complex dressings Plaster check Immunization only Behavioural / psychiatric Known patient with chronic symptoms Social crisis, clinically well patient |
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