Share your triage experience


Do you have feedback or questions? The survey creators welcome your thoughts. Feel free to reach out to Elena Drews, MD, at edrews@mednet.ucla.edu or Jason Chiang, MD, PhD, at CJChiang@mednet.ucla.edu.


and create a framework that improves efficiency, communication, and more importantly—patient care.”


The first round of the survey has closed with 69 responses, but researchers have recently opened round two, which includes changes based on feedback.


“For example, we added femoral artery access site pseudoaneurysm as a triage category based on suggestions from the community. We’re also working to refine and clarify clinical scenarios so the system can be easily used by anyone involved in triaging cases—whether that’s a trainee, an advanced practice provider or an attending physician,” they said.


Early review of the data has also reiterated how difficult it is to establish a standardized approach.


“One issue that has come up is the importance of clinical judgement in triaging patients,” Drs. Chiang and Drews said. “For example, a patient who has a traumatic active hemorrhage, who is hypotensive and tachycardic, is presumably more emergent than a patient with active bleeding whose vital signs are stable. Similarly, a patient with pyonephrosis will likely require more urgent a nephrostomy placement than


a patient with hydronephrosis with no signs of sepsis.”


Some respondents have said that because these nuances, it is impossible to establish a standardized IR triage system. Drs. Chiang and Drews disagree.


“These differences occur in trauma and acute care surgery, and other specialties with triage guidelines as well,” they said. “We do not intend for our guidelines to represent a definitive standard of practice, but rather a framework and shared resource. Ultimately IRs will still need to use clinical judgement, but our hope is that the guidelines are a useful adjunct.”


Another concern expressed in survey responses is that by reducing clinical expertise to a set of procedures, IRs may ultimately make themselves a commoditized entity.


“Our argument against that is that the procedures themselves, regardless of where they fall within the triage system, still require clear clinical judgement, imaging and technical expertise, and management of complex decisions,” Drs. Chiang and Drews said.


Drs. Chiang and Drews ultimately plan to submit their findings and experience for


irq.sirweb.org | 19


publication. They also hope to present their results at SIR 2026, as well as set up another Town Hall discussion to gather more feedback and identify the best paths for implementation.


“In many ways, we view this initial system as just the first step—the foundation for what we hope will become a broad, impactful initiative that improves consistency, efficiency and patient outcomes across IR,” Drs. Chiang and Drews said.


Anyone interested in participating may currently submit their responses to round two of the survey, which has been amended to be shorter, easier-to-understand and more accessible for respondents.


“We know it will not capture everything that one encounters in the middle of the night,” Drs. Chiang and Drews said. “But we hope everyone participates in this second-round survey! The more responses we get, the better the system will be.”


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