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Appendix 8: Patient classification system for emergency/disaster management
Further details and examples are available in Sienkiewicz et al. 66
The authors describe a three level system of classification for care of patients in the community.
Level 1: Highest priority
Patients in this priority level need uninterrupted services. Deterioration of the patient's condition or inpatient admission is likely to occur if the patient is not seen. Examples cited in this category included patients who are ventilator-dependent, who need extensive wound care, or who need daily assistance to meet physical health needs.
Level 2: Moderate priority
The patient in this category is described as requiring a moderate level of skilled care. Care may be able to be delayed until the emergency is contained. Examples cited include patients who use equipment as needed (oxygen, nebulisers, patient controlled analgesia pump) or patients with multiple medication changes in the previous 1-2 weeks
Level 3: Low priority
The patient in this priority level is described as able to "safely forgo care or a scheduled visit without a high probability of harm or deleterious effects. The patient is able to manage alone for several days or longer, or may have significant others or available support systems in place." Examples cited include patients who need uncomplicated routine wound care or patients who are mobile and independent in functioning.
The dynamic nature of the patient classification is stressed, with a patient being allocated to a different priority level as circumstances and care needs change. The time frame for patient visits is deliberately not included, recognising
"that numerous factors may affect each agency's ability to respond, including the time, type and location of the disaster, the available personnel and the care requirements of the patients."
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