EMERGENCY PATIENTS WILL BE PRIORITISED INTO THREE CATEGORIES

As of 16th of November 2016, all emergency patients in Bulgaria will be prioritized on the basis of a triage tool to identify the urgency of treatment for the patients' conditions. Testing of the triage instrument will be performed.

The triage instrument is introduced in the country for the first time. The old standard for emergency care in Bulgaria determined as urgent any patient who considered himself of herself as such. This system deformed the expectations of the public from the emergency care medical teams and therefore the essence of their work.

The triage instrument will be tested in order to train and improve the skills of the health care workers in the coordination units and to enable the patients looking for urgent medical help to get informed about the new system and the meaning of its application.

Triage is a process determining the priority of the patients’ treatment into three categories.

Red Code – critical emergency – patients who need immediate treatment or life-saving medical intervention

Yellow Code – requires urgent, not immediate medical care

Green Code – non-urgent - requires an examination by a medical team

The RED colour code refers to patients whose lives are in immediate danger, with impaired respiratory, circulatory and neurological functions. The YELLOW colour code refers to patients with potential danger for their lives, with progressing heavy symptoms that may lead to complications and heavy consequences for vital functions. The GREEN colour code refers to patients who do not have lower potential for complications and heavy consequences.

The prioritising into the three categories will be done on the basis of an assessment interview over the phone. The purpose of the interview to get the maximum information through minimum questions about the condition of the patient and severity of the symptoms. Most important are the first questions – what happened, where and how many need medical help. For instance, in the event of heavy car accidents, with many injured, the operator answering the phone is obliged to activate RED code and inform the emergency teams.

As soon as the code is activated and sent to the teams, the interview may go on in order to provide additional information to the medical team while traveling to the patient.

When necessary, the operator may give guidance to the people around the patient, which can be applied while waiting to be seen by the emergency team.

Currently, the Ministry of Health carries out training across the country in the medical emergency centres in relation to the testing of the triage system. After the end of the training, a meeting at national level will summarize the results and problems.