Emergency Severity Index (ESI): A Triage Tool for Emergency Department

Table 6-2. Examples of ESI Level-1 Conditions

Respiratory arrest
Cardiopulmonary arrest
Major head trauma with hypoventilation
Active seizures
Peticheal rash in a patient with altered mental status (regardless of vital signs)

Respiratory failure:

  • Hypoventilation.
  • Cyanosis.
  • Decreased muscle tone.
  • Decreased mental status.
  • Bradycardia (late finding, concerning for impending cardiopulmonary arrest).

Shock/sepsis with signs of hypoperfusion:

  • Tachycardia.
  • Tachypnea.
  • Alteration in pulses: diminished or bounding.
  • Alteration in capillary refill time >3-4 seconds.
  • Alteration in skin appearance: cool/mottled or flushed appearance.
  • Widened pulse pressure.
  • Hypotension (often a late finding in the prepubescent patient).

Anaphylactic reaction (onset in minutes to hours):

  • Respiratory compromise (dyspnea, wheeze, stridor, hypoxemia).
  • Reduced systolic blood pressure.
  • Hypoperfusion (eg, syncope, incontinence, hypotonia).
  • Skin and/or mucosal involvement (hives, itch-flush, swollen lips, tongue or uvula).
  • Persistent gastrointestinal symptoms.

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Page last reviewed October 2014
Page originally created September 2012
Internet Citation: Table 6-2. Examples of ESI Level-1 Conditions. Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/esi/esitab6-2.html