For a serious or urgent injury or illness, go straight to the emergency triage desk and don't line up at the registration window

Cost

Free. Walk a few more steps after you enter to find the triage desk. State the most dangerous symptom in one sentence.

What you get

The National Health Commission's 2024 emergency medicine quality control indicators require pre-exam triage in emergency care to “sort patients into four levels by the seriousness of their condition.” “Level I is critical and life-threatening, requiring immediate treatment.” “Level II is urgent and serious, where assessment and treatment often happen at the same time.” “Level III is urgent, requiring diagnosis and treatment within a short time.” “Level IV is non-urgent or sub-urgent, seen in order in the general treatment area.” Pre-exam triage means a designated person first assesses how serious your condition is when you enter the emergency department, and sets the order of care. Beijing's implementation standard spells out the response required at each level. Level 1: “immediate assessment and treatment; the patient is sent to the resuscitation room or rescue room.” Level 2: “immediate monitoring of vital signs, treatment within 10 minutes, the patient is sent to the rescue room.” Level 3: “treated ahead of Level 4 patients, and waits in the general treatment area; if the wait is longer than 30 minutes, a reassessment is needed.” Level 4: “seen in order; unless the condition changes, the wait is longer; if the wait is longer than 4 hours, a reassessment is possible.” In the Beijing standard, the manual criteria for Level 1 include “acute disturbance of consciousness.” Those for Level 2 include “active or severe blood loss,” “severe difficulty breathing,” “chest pain resembling a cardiac cause,” and “severe pain from any cause (7–10 points).” Triage must “keep to the principle that critical and life-threatening cases are seen first,” and the emergency department entrance should have a pre-exam triage area in a prominent place (the four-level standard is nationwide; the response times are Beijing's standard).

Notes

The four levels are the same nationwide. How soon each level is handled is set by each province and city; Beijing's is a version that can be checked word for word. The level is set by indicators such as heart rate, blood pressure and blood oxygen, and by symptoms; the degree of pain is one of them, and pain of 7 to 10 can put you at Level 2. The hard criteria for Level 1 include the following. First, heart rate above 180 beats per minute or below 40 beats per minute. Second, systolic pressure below 70 mmHg; systolic pressure is the higher number in a blood pressure reading. Third, blood oxygen below 80%. Fourth, shock, a clear heart attack, or acute disturbance of consciousness. If you feel triage has put you too low, add the most dangerous symptom and say it clearly. If your condition changes while you wait, go back to the triage desk right away to be assessed again. When it is truly critical, call 120 (China's ambulance number; see §13). Beijing's plan requires pre-hospital emergency doctors to give each patient a first grading by the standard, and for Level 1 and 2 patients to promptly notify the emergency department of the hospital the patient is going to, so it can prepare to receive them.

Evidence grade

A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.

Sources

1. General Office of the National Health Commission (2024). Notice on issuing the medical quality control indicators (2024 edition) for 6 specialties including emergency medicine (General Office of the National Health Commission Medical Administration Letter [2024] No. 150), Annex 1, indicator 4 "emergency triage implementation rate" [in Chinese]. https://www.gov.cn/zhengce/zhengceku/202405/content_6951260.htm
2. Beijing Municipal Health Commission (2019). Beijing work plan for strengthening emergency pre-examination triage and its annex, the "Beijing Hospital Emergency Pre-examination Triage Standards (Trial)" [in Chinese]: "Adhere to the principle of seeing critically ill and urgent patients first. According to the severity of the patient's condition, and following the order from severe to mild and from rapidly changing to relatively stable, arrange the order of treatment reasonably." "Set up an emergency pre-examination triage area in a prominent location at the entrance of the emergency department" "Pre-hospital emergency physicians should make a preliminary classification of patients according to the relevant standards, and promptly notify the emergency department of the receiving hospital to prepare for Level 1 and Level 2 patients". http://wjw.beijing.gov.cn/zwgk_20040/ylws/201912/t20191216_1242338.html

Translated from the Chinese original. Original book, section 24, tip 7. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer