Veterinary Triage Essentials for Emergency Techs

Claire Brooks

Welcome to the very first episode of the AVS Veterinary Team Training Podcast, a podcast created to help our team strengthen clinical skills, communication, confidence, and teamwork. I’m Claire, your host, and today we’re starting with one of the most important skills in emergency medicine: triage

Claire Brooks

Joining me is Oliver. Oliver, why did triage feel like the right place to begin this podcast

Oliver Hart

Because triage is where emergency care begins. Before diagnostics, before treatment plans, before hospitalization, someone has to answer a very basic but incredibly important question: how sick is this patient, and how quickly do they need help? At AVS, veterinary technicians play a central role in making that first assessment. And when you do triage well, you can change the entire trajectory of a case

Claire Brooks

So this is really more than taking vitals and assigning a color

Oliver Hart

Exactly. Great triage is recognizing, sorting, communicating, and acting. The goal is simple: the sickest patients are seen first. Not necessarily the patient who arrived first, or the client who is the most upset. We are prioritizing based on physiology and urgency

Claire Brooks

Walk us through the technician’s role in that first moment

Oliver Hart

The CSR team is often our first set of ears and eyes, and then the technician performs the clinical assessment. Your role is not to diagnose the patient. Medical decisions belong to the veterinarian. Your role is to perform a fast, accurate assessment, identify the appropriate triage level, communicate what you are seeing, and escalate when necessary. And I want technicians to really hear this: noticing something is wrong and speaking up is clinical leadership. You do not have to know the final diagnosis to recognize respiratory distress, poor perfusion, abnormal mentation, or a patient that may be crashing

Claire Brooks

That feels important, especially for someone newer who may worry about being wrong

Oliver Hart

Absolutely. Clinical confidence does not mean knowing everything. It means having a reliable system to fall back on and knowing when to pull in the doctor. When in doubt, triage up and call the doctor. Escalation is a strength, not a failure

Claire Brooks

Let’s make the workflow really practical. What happens when a patient arrives

Oliver Hart

Every emergency patient should be assessed by a trained technician or supervising clinician and assigned a triage level within the first few minutes. The mental flow I want people to remember is: respond, look, assess, classify, communicate, act, reassess, and document

Claire Brooks

And there are two different triage pages at AVS, right

Oliver Hart

Yes. A standard ‘Triage’ page through the intercom means the triage technician should reach the lobby within two minutes. ‘Triage STAT’ or the STAT triage alarm bell means respond immediately. If the patient is truly critical, that patient goes directly to the treatment area. I like to think of the page as a promise between departments. When the CSR calls for triage, they need to know someone is moving. And when they call Triage STAT, the entire team should understand that the clock is already running

Claire Brooks

Once you get to the patient, what do you do first

Oliver Hart

Before you touch the patient, look. Survey from a distance. How are they positioned? Are they standing or collapsed? Open-mouth breathing? Using the abdomen to breathe? Mentally appropriate? Weak? Restless? Obtunded? Bleeding? Do they look like a patient who can safely remain in the lobby

Claire Brooks

So we’re using pattern recognition before we even put our hands on them

Oliver Hart

Exactly. Experienced technicians develop a strong sense of what normal looks like and what does not. Trust that instinct, then validate it with a systematic assessment. At AVS, one of our key frameworks is RAP: Respiration, Alertness, Perfusion

Claire Brooks

Let’s take those one at a time. Respiration first

Oliver Hart

Any meaningful change in breathing gets your attention. Clients may call true respiratory distress ‘panting’ or ‘anxiety,’ so we have to assess the pattern ourselves. Look for shallow breathing, increased effort, abdominal effort, noise, irregularity, open-mouth breathing—especially in a cat—or a patient that is not breathing at all. Then look at mucous membranes. Muddy, blue, grey, or pale membranes are abnormal. Cyanosis is an immediate emergency

Claire Brooks

And restraint can matter in those patients too

Oliver Hart

Very much. Respiratory patients can worsen with stress. Sometimes excellent emergency medicine means doing less at first: minimizing stress, recognizing instability, and getting the patient to the treatment team quickly

Claire Brooks

Next is alertness

Oliver Hart

Ask whether the patient’s brain is interacting normally with the environment. We think of level of consciousness along a progression: alert, depressed, delirious, stuporous, comatose. A patient who came in for ‘not acting right’ but is now stuporous is telling you something very different from a bright, responsive patient with the same history. The history never overrides abnormal physiology

Claire Brooks

And P is perfusion

Oliver Hart

Right. Look at mucous membrane color, capillary refill time, heart rate, and pulse quality. Then put those findings together. Are the gums pink? Is CRT normal? Are the femoral pulses strong, weak, bounding, or irregular? Does the pulse you feel match the heartbeat you hear? A nonsynchronous heart and pulse rate can be an early sign of shock. This is where technicians become powerful clinical thinkers. You are not just writing down ‘heart rate 180.’ You are integrating heart rate 180, weak pulses, pale gums, prolonged CRT, quiet mentation. That collection of findings tells a story

Claire Brooks

The protocol also uses ABC. How does that fit with RAP?

Oliver Hart

They complement each other. At AVS, ABC stands for Attitude, Breathing or Bleeding, and Cardiovascular or Circulation. Ask: is the patient mentally appropriate? Is respiratory rate and effort normal? Is there active bleeding, and is it compressible? Are heart rate and rhythm appropriate? Are pulses strong and synchronized? Are gums pink? Is CRT in a normal range

Claire Brooks

What vital signs should technicians know cold?

Oliver Hart

Species and size matter. For dogs, normal heart rate varies with body size. Dogs under thirty pounds are generally around 100 to 140 beats per minute, thirty- to fifty-pound dogs around 80 to 120, and dogs over fifty pounds—or very calm relaxed dogs—may be around 60 to 80. In our AVS reference, a dog heart rate over 160 or under 60 is an emergency threshold. For cats, normal heart rate is approximately 170 to 200, with less than 160 or greater than 240 considered an emergency finding

Claire Brooks

I like that you emphasized effort, not just the number.

Oliver Hart

Exactly. A patient does not need to cross a magical numerical threshold to be in distress. Effort matters. Mucous membranes should be pink. Any other color is concerning. Normal CRT is under two seconds; less than one or greater than three seconds is an emergency finding in the AVS reference. Normal temperature is around 100 to 102.5 Fahrenheit. Below 99 or above 105 is an emergency threshold. And the key is: never interpret a number in isolation.

Claire Brooks

Once the assessment is complete, we classify the patient as red, yellow, or green. Start with red

Oliver Hart

RED is Level One—critical. This is a patient with abnormal vital signs or a serious problem where death could occur rapidly without immediate care. They do not wait. Begin ABC within 60 seconds, notify a veterinarian immediately, and move the patient directly to treatment. Before taking a critical patient away from the owner, ask permission to begin life-saving care and confirm CPR versus DNR status whenever the situation allows. Then the owner can be placed in a room to complete paperwork while the team stabilizes

Claire Brooks

What findings should trigger immediate doctor notification.

Oliver Hart

Respiratory distress or cyanosis, collapse or altered consciousness, active heavy bleeding, suspected GDV—especially a distended abdomen with retching—active or repeated seizures, dangerously abnormal heart rates, or any patient your clinical instinct tells you could crash. If you are worried, speak up

Claire Brooks

Then YELLOW

Oliver Hart

YELLOW is Level Two—urgent. These patients may not require resuscitation this second, but they could deteriorate or develop severe pain. They need active attention and reassessment every 15 to 30 minutes

Claire Brooks

That reassessment piece seems easy to overlook when the ER gets busy.

Oliver Hart

It is, and that is why it is so important. Triage is not permanent. A yellow patient can become red. Never think, ‘I already triaged that patient.’ Think, ‘That was their status then. What is their status now?’ If they worsen, upgrade the level and alert the veterinarian

Claire Brooks

And GREEN?

Oliver Hart

GREEN is Level Three—stable. Vitals are normal, the problem is not immediately life- threatening, and the patient is unlikely to deteriorate while waiting. These patients can complete paperwork and wait in the lobby. But green does not mean nothing is wrong. It means the patient’s current physiology tells us they can safely wait while more critical patients receive care

Claire Brooks

The protocol has a special note about cats and critical patients

Oliver Hart

Yes. Cats and critically ill patients are assessed in the treatment area rather than the lobby. Stress matters, and so does rapid access to oxygen, medications, monitoring, ultrasound, and the medical team. For STAT arrivals, the CSR can fast-start the case by entering at minimum the patient’s first and last name in EzyVet and saving the record to generate a patient ID. That lets the medical team begin moving quickly—preparing medications, running point-of-care ultrasound, and initiating emergency care

Claire Brooks

That really highlights that triage is a team process, not just a technician task

Oliver Hart

Exactly. The CSR is not ‘just checking someone in.’ The technician is not ‘just taking vitals.’ The doctor is not working independently. Every person is part of the same chain, and speed comes from everyone knowing their role

Claire Brooks

Let’s talk about client communication. The owner may be terrified in that moment

Oliver Hart

Yes, and calm is contagious. Introduce yourself as a technician, explain that you are doing a quick assessment to determine how urgently their pet needs to be seen, ask about handling concerns, and ask permission to take the pet to treatment when appropriate. A simple script might be: ‘Hi, I’m one of the veterinary technicians. I’m going to do a very quick assessment so we can determine how urgently your pet needs to be seen.’ Then: ‘I’d like to take her to our treatment area for a quick set of vital signs and assessment. I’ll come back and update you as soon as I’ve completed that check

Claire Brooks

Clear, calm, and confident

Oliver Hart

Exactly. Clients borrow our nervous systems. When we are calm and purposeful, we communicate: your pet is in capable hands. And when you report to the doctor make it brief and clinically useful. Instead of ‘Can you look at this dog? He doesn’t look good,’ say: ‘I have a RED triage. Twelve-year-old Labrador, collapsed at home. Depressed mentation, pale mucous membranes, CRT greater than three seconds, heart rate 180 with weak femoral pulses. He’s in the ICU now. You are communicating patient, problem, physiology, urgency, and action. That is a much more useful handoff

Claire Brooks

What needs to be documented?

Oliver Hart

Document the presenting complaint, mentation, respiratory rate, mucous membrane color and CRT, heart rate, femoral pulse quality, and triage classification. Phone-triage information should be documented in EzyVet as a communication. Call-ahead patients should be relayed to the team and noted on the ER schedule

Claire Brooks

And triage does not end at the front door

Oliver Hart

Right. Triage is not a location. It is a skill you use all shift. If a hospitalized patient changes, run the same process: step back, look, RAP, ABC, vitals. Ask what changed, how quickly it changed, and whether the patient needs escalation

Claire Brooks

Before we wrap up, what do you want every AVS technician to remember from this episode?

Oliver Hart

First: look before you touch. Second: trust your training and know your numbers. Third: communicate what you see. Fourth: reassess. And finally, when in doubt, triage up and call the doctor. Emergency and specialty medicine do not work without highly skilled veterinary technicians. You are often the person who notices first—the weak pulse, the breathing pattern, the abnormal gum color, the change in mentation. Sometimes the sentence ‘I need a doctor now’ can change everything. Clinical confidence is not knowing everything. It is having a systematic approach so that when the pressure rises, your training takes over: respond, look, RAP, ABC, vitals, classify, communicate, and document

Claire Brooks

I think the AVS Triage Protocol is a wonderful promise to owners and their pets. If people have questions after listening, who should they go to?

Oliver Hart

Yes, we welcome any and all questions. Any questions related to AVS emergency care protocols can be directed to ECC Leads Technician, Kelsie Schulz or directly to Dr. Sikina. Questions or comments can also be dropped into the AVS All Together Team's channel under this episode's post. We'd like all of our staff and to feel very comfortable with the triage promise and to start implementing today.

Claire Brooks

That sounds wonderful. Well that's a great place to wrap up this episode. Thank you for listening to the AVS Veterinary Team Training Podcast. Keep learning, keep asking questions, keep supporting each other, and keep leading advanced care