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Veterinary Triage Assessments

Triage is the process of organising patients according to the severity of their condition and ensuring each patient receives treatment within an appropriate time frame. As a veterinary professional - assessing patients quickly, thoroughly, and accurately is essential in ensuring animals get the care they need when they need it, as well as making sure your practice is operationally sound.


Effective triage should be implemented at every stage of patient care. From the initial phone call to the patient’s arrival, an accurate assessment of a patient’s condition ensures each patient receives the care it needs, and you are prepared to deal with that patient’s condition.

In this complete guide to veterinary triage, we will cover the following:

  • How to Execute Effective Veterinary Triage
  • Veterinary Triage Over the Phone
  • Evaluating Emergencies & Defining Non-Urgent Issues
  • Examples of Veterinary Triage Questions
  • Severe Emergencies
  • Face to Face Triage


  • Veterinary Triage Assessments
  • Triage for Wound Patients – Additional Steps
  • The Veterinary Triage List
  • The ADCDE Triage Approach
  • Animal Trauma Triage System (ATT)


How to Execute Effective Veterinary Triage

Performing rapid and accurate triage assessments is a skill that is mastered and refined over time. Every practice must have a triage protocol in place, and each member of staff should be trained in how to triage patients effectively. Triage is assessed differently throughout the continuum of care, and at each stage there are various methods and approaches for carrying it out effectively. This article will cover these approaches from the initial telephone call to the hands-on patient assessment. 

Veterinary Triage Over the Phone

In most cases, triage assessments start with a phone call. Receptionists will be the first point of contact in these cases, thus an accurate assessment here is vital to ensure the priority of cases. If a mistake or inaccurate assessment is made at this point, this could put unnecessary stress on the team within a practice or risk a patient’s life. Receptionists need to be aware of the questions to ask pet owners, to determine how urgently the patient needs to be seen.

Evaluating Emergencies & Defining Non-Urgent Issues

When a call comes in from a concerned pet owner, it’s the receptionist’s role to determine whether they should be booked into the next available appointment or should be seen straight away. This is vital as many practices are facing high demand and may not have an available slot for several days. Making this judgement call is an important skill from both a medical, and practice management standpoint.

  1. Gather the patient’s details

    2. The first thing to do is ask the pet owner if they are a client. If they are a client, the practice should have the patient’s details on record. This will speed up this step, allowing the receptionist to move into the next assessment step. If the caller is not a client, and the practice doesn’t have the patient’s details, the receptionist must obtain their age, sex, reproductive status, species, and breed. This will help assess the severity of the case, as a 7-year-old canine who has not eaten for 24 hours, is far less likely to be an emergency than a 2-month-old puppy that has not eaten for 24 hours

  2. Understand the issue

    3. The next step is to understand the patient’s concerns and build an understanding of the case at hand. It’s important here to ask open-ended questions, allowing the owner to go into detail and provide context. This is because close-ended questions could influence the owner’s response or not provide the level of detail required, which only leads to more questions, more time, and frustration for both the receptionist and the pet owner.

Examples of Veterinary Triage Questions
  • Can you explain what the problem is and when it started?
  • What symptoms are you seeing, and how long have these been presenting?
  • Is there anything that has happened, which is outside of normal routine (i.e. eating something different)?
  • Ask for any packaging of any medicines or food that has been ingested (if applicable)



When assessing a patient’s condition over the phone, there are a series of symptoms that will tell you if this is an emergency. If the pet owner mentions any of the following, the patient should be seen as soon as possible.

  • Severe pain
  • Breathing difficulty
  • Failure to urinate
  • Seizures
  • Severe vomiting and/or diarrhoea
  • Continuous  bleeding
  • High temperature
  • Seen or suspected trauma
  • Unresponsiveness
  • Collapse
  • Cyanosis
  • Consumption of a toxic substance

Severe Emergencies

Sometimes a practice may receive a call where a patient is suffering life-threatening injuries. These could have occurred from a road accident, an altercation with another animal, or any other causes. The owner may already be on their way, if not they should be urged to travel to practice immediately. In these cases, it’s more important to get the patient to a vet than conduct an initial assessment (mentioned above).

When prior notice is given, the receptionist should notify the relevant surgeons and vet nurses, so they can be prepared for the arrival of the patient. This gives them time to ensure a room is free and supplies are gathered.

If a practice is not equipped to handle severe emergencies, due to staffing, equipment, or another factor – the pet owner should be referred to the nearest emergency clinic. If the practice has the patient record on hand, it’s a good idea to contact the referral practice to provide them with as much detail as possible, so they can be prepared and deliver the best form of care.

Face-to-Face Triage

There are instances where triage over the phone cannot or did not take place, such as a pet owner turning up to reception unannounced with no prior call. In these cases, if the patient is not a category 1 (emergency) the same steps as detailed above should take place, to obtain details about the patient and quickly assess the patient’s condition (if not life-threatening). Once a patient has had a face-to-face or telephone assessment and is present in practice, their main body systems should be checked.

Veterinary Triage Assessments

When your practice is presented with a patient, their core body systems need to be assessed quickly and effectively. This will ensure any critical issues are stabilised and they get the correct care and initial treatments required. There are several different triage scoring methods used in the veterinary industry to assess the patient’s condition and help determine the proper treatment, as well as prioritise the urgency of the case.

Triage for Wound Patients – Extra Measures

Before we delve into the different models for assessing a patient’s core body system, there are key steps that need to be taken to triage patients with wounds:

  • Always wear PPE ( personal protective clothing) when handling patients with wounds
  • Keep patients warm with blankets, foil blankets or heat pads
  • Use an Inco sheet ( absorbent pad) under the patient if the patient decides to lie down to prevent the wound from touching the floor
  • Attend to the patient in a clean room – ideally a separate wound room
  • Measure the patients TPR (temperature, pulse, respiration) – a dog muzzle should be considered for dogs as the pain score is often high with wound cases
  • Check the patient's reflexes
  • Take pictures of the wound
  • Note what structures have been damaged
  • Measure the injury for accurate size

The Veterinary Triage List (VTL)

Many veterinary professionals use a Veterinary Triage List (VTL). This was developed by Ruys et al (2012), using the widely known Manchester Triage Scale (MTS), but focused on veterinary care. The triage system was divided by body system: respiratory, circulatory, neurological, obstetrical, gastrointestinal, urogenital and generalised, with different grades of severity requiring different waiting times. The VTL is a process of categorising the patient’s condition and giving them a scoring based on colour. This colour will indicate the urgency of the case and the target waiting times. Using a VTL is a great way to manage the practice waiting room/list and ensure the correct prioritisation of patients to be seen.

The ADCDE Triage Approach

Another method used by Gerardo Poli for triage is the ABCDE approach. The Vet Times cover a 2-part series explaining how this approach is split into a primary assessment and a secondary assessment for critical patients. This approach sets out to first preserve life, manage life-threatening injuries and re-establish tissue perfusion with oxygenated blood; allowing you to re-assess the patient once stabilised.

The approach:

  • A irway assessment
  • B reathing Assessment
  • C ardiovascular system assessment 
  • D isability assessment
  • E xternal assessment

    • View the full assessment here.

Animal Trauma Triage System (ATT)

The Animal Trauma Triage (ATT) system assesses the patient’s core body systems, grading them based on the severity of the injury. The body systems assessed are perfusion, cardiac, respiratory, eye/muscle/integument, and skeletal. This model adds up to a total ATT score of 18 which allows veterinary professionals to categorise the priority of patients based on how high their score is. “Each point increase in the ATT score resulted in a 2.3–2.6 times decreased likelihood of survival" (Journal of Veterinary Emergency and Critical Care. 2007;4(2):77–83).

Conclusion

It's of paramount importance that everyone from the receptionist to the surgeon in the practice is trained in triage. Everyone plays a vital part in this protocol; receptionists need to be trained in the questions to ask to determine how urgently the patient needs to be seen, as they are the most commonly the first point of contact. The practice should be well-equipped to deal with any emergency, and if not, a process needs to be in place to refer patients to a suitable practice in such cases. All veterinary surgeons and veterinary nurses should be trained in how to assess the three major body systems. Everyone's training when determining if a patient has a life-threatening condition should be continually refreshed.