How would you prioritize and categorize each of these patients?

The following four patients present to the triage desk of the ED within minutes of each other. How would you prioritize and categorize each of these patients? Which ones need immediate attention? What initial care would you provide at triage? Which patient could wait or be sent to the clinic for management?

a.       A college student runs to the triage desk and screams, “My buddy is in the car outside—I think he stopped breathing!” The student appears disheveled and reeks of alcohol; he appears to have splattered vomitus across his chest.

b.      A woman presents cradling her left forearm in her right hand. Her husband tells you that she fell down the steps at home and he thinks she broke her arm. Her eyes are downcast, she does not speak for herself, and she is crying softly. She has a fresh bruise on her left eye that appears to be swollen shut, and there is blood trickling from her tightly closed, quivering mouth. Her husband insists that he wants to be with her during her assessment.

c.       A middle-aged woman experiences sudden dyspnea and midscapular back pain while making dinner. Instead of calling 911, she takes an aspirin and her husband drives her to the ED. She is now complaining of left scapular pain and tingling in her left arm, her skin appears ashen, and she is diaphoretic.

d.      A middle-aged man who is obese and has a known history of diabetes presents with complaints of a high fever that has waxed and waned over the course of the past 48 hours. His vital signs are normal, but he is diaphoretic and appears weak.

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