Cot 2012 English Canada v02.02 1 0

Complaint Oriented Triage 2012 – Canadian Triage and Acuity Score 2012
Go to Pediatric COT
Substa Mental ENT - Cardio OB- Gen- Environ Gene
Neuro Ophth Nose Ears Resp G. I. Ortho Trauma
ment
Skin
buse Health other Vasc GYN Urin ral
Go to Adult COT
ADULT COT
Complaint Oriented Triage
COT 2012 - (English Canada Version 02.02)

based on the
Canadian Triage and Acuity Score (CTAS 2012),
Pediatric CTAS (Ped-CTAS 2012) and the Mod
Canadian Emergency Department Information System (CEDIS) Adult
CNS
2012 Chief Complaint list v2.0 Hemo
dyn
Resp
Edited by Bernard Unger, Michael Bullard, David Meurer
CTAS National Working Group
Temp
© Canadian Association of Emergency Physicians

Pain
BD
MOI
Def.
Last slide
viewed
Complaint Oriented Triage 2012 – Canadian Triage and Acuity Score 2012 2
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
COT Contributors
Bernard Unger Michael Bullard

Sir Mortimer B. Davis-Jew ish General Hospital, McGill University, Montreal University of Alberta Hospital, University of Alberta, Edmonton
David Meurer RN
Alberta Health Services, Edmonton
Original COT Contributors
Afonso, Fernando N, SMBD-Jew ish General Hospital, Montreal Policicchio, Carla RN, Alberta Health Services, Edmonton
Bell, Jerry RN, Regina Qu'Appelle Health Region Emergency, Pasqua Site Scheidman, Valerie N, SMBD-Jew ish General Hospital
Bernardin, Bruno MD, McGill University Health Centre, Montreal Sheridan, Melanie N, SMBD-Jew ish General Hospital, Montreal
Brayman, Colleen RN, Interior Health Region, Kelow na Stackhouse, Sherry EN, Lion's Gate Hospital, Vancouver Mod
Bullard, Michael MD, Alberta Health Services, Edmonton Stang, Claude RN, Vancouver General Hospital, Vancouver Adult
Cotton, Debbie N GASHA, Antigonish NS Unger, Bernard MD, SMBD-Jew ish General Hospital, Montreal CNS
Dymond, Margaret RN, Alberta Health Services, Edmonton Vadeboncoeur, Alain MD, Institut de Cardiologie de Montréal, Montreal
Hemo
Francis, Fiona RN, Richmond General Hospital, Vancouver Warren, David MD, Children’s Hospital of Western Ontario, London dyn
Grafstein, Eric MD, St.Paul's Hospital, Vancouver Westman, Julie RN, St. Paul's Hospital, Vancouver
Resp
Gravel, Jocelyn MD, Centre hospitalier universitaire Ste. Justine, Montreal White, Laura Consultant Vancouver Coastal Health Authority, Vancouver
Latoszek, Karen RN, Alberta Health Services, Edmonton Temp
McLaughlin, Monique RN, Vancouver General Hospital, Vancouver and
Pain
The CTAS National Working Group
The Pediatric CTAS NWG Subcommittee BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT Complaint Oriented Triage 2008
Substa Mental
– Canadian
ENT - Cardio
Triage and
OB-
Acuity
Gen-
Score 2008
Environ Gene
ment
Skin
Go to Adult COT
Age selection
ADULT COT
< 17 17 +
years old years old Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Title page
Go to Pediatric COT
ment
Skin
Go to Adult COT
Substance Misuse (Subst) ENT – Nose CardiovascularMaster list Genitourinary (Gu) Skin (Skin)
ADULT COT
Substance misuse / Intoxication Epistaxis Cardiac arrest (non traumatic) Flank pain Bite
Overdose ingestion Nasal congestion / Hay fever Cardiac arrest (traumatic) Hematuria Sting
Substance withdrawal Foreign body, nose Chest pain (cardiac features) Genital discharge / lesion Abrasion
URTI complaints Chest pain (non cardiac features) Penile swelling Laceration / Puncture
Mental health & psychosocial Nasal trauma Palpitations / Irregular heart beat Scrotal pain and/or swelling Burn
Depression / Suicidal / Deliberate self harm Hypertension Urinary retention Blood and body fluid exposure
Anxiety / Situational crisis General weakness UTI complaints Pruritus
Hallucinations / Delusions Syncope / Pre-syncope Oliguria Rash
Insomnia ENT – Ears
Edema, generalized Polyuria Localized swelling / redness
Violent / Homicidal behavior Earache
Bilateral leg swelling / Edema Genital trauma Wound check
Social problem Foreign body ear
Cool pulseless limb Other skin conditions
Bizarre behaviour Loss of hearing
Unilateral reddened hot limb Lumps, bumps, calluses
Concern for patient's welfare Tinnitus
Paediatric Disruptive behaviour Orthopedic (Ortho) Redness / tenderness, breast
Discharge, ear Gastrointestinal (GI)
Back pain Rule out infestation
Ear injury Abdominal pain
Traumatic back / spine injury Cyanosis
Anorexia Spontaneous bruising
Amputation
Constipation Foreign body, skin
Neurologic (Cns) Upper extremity pain
ENT – Mouth, Throat, Neck Diarrhea Removal staples / sutures
Altered level of consciousness Lower extremity pain
Dental / Gum problems Foreign body in rectum
Confusion Upper extremity injury
Facial trauma Groin pain / mass
Vertigo Lower extremity injury General & Minor (Gen)
Sore throat Vomiting and/or nausea
Headache Joint(s) swelling Exposure to communicable disease
Neck swelling / pain Rectal / Perineal pain
Seizure Paediatric gait disorder / painful walk Fever
Neck trauma Vomiting blood
Gait disturbance / Ataxia Cast check Hyperglycemia
Difficulty swallowing / Dysphagia Blood in stool / Melena
Head injury Hypoglycemia
Jaundice
Tremor
Facial pain (non-traumatic / non-dental)
Direct referral for consultation Mod
Hiccoughs Trauma (T) Adult
Extremity weakness / Symptoms of CVA Abdominal mass / distention
Dressing change
Sensory loss / Parasthesias Major trauma – penetrating Imaging tests
Anal / Rectal trauma
Major trauma – blunt CNS
Floppy child Oral / Esophageal Foreign Body Medical device problem
Isolated chest trauma – penetrating Prescription / Medication request
Feeding difficulties in newborn Hemo
Isolated chest trauma – blunt Ring removal dyn
Ophthalmology (Ophth) Neonatal jaundice
Respiratory (Resp) Isolated abdominal trauma – penetrating
Abnormal lab values
Chemical exposure, eye Shortness of breath Ob – Gyn (Ob - Gyn) Isolated abdominal trauma – blunt Resp
Pallor / Anemia
Foreign body, eye Respiratory arrest Menstrual problems Post-operative complications
Visual disturbance Cough / Congestion Foreign body, vagina Inconsolable crying in infants Temp
Eye pain Hyperventilation Vaginal discharge ENVIRONMENTAL Congenital problem in children
Red Eye, discharge Hemoptysis Sexual assault Frostbite / Cold injury
Photophobia
Minor complaints NOS Pain
Respiratory foreign body Vaginal bleed Noxious inhalation Newly born
Diplopia Allergic reaction Labial swelling Electrical injury
Periorbital swelling Stridor Pregnancy issues < 20 wks Chemical exposure
BD
Reference: Grafstein E, Bullard MJ,
Eye trauma Wheezing – no other complaints Pregnancy issues > 20 wks Hypothermia Warren D, Unger B, the CTAS National
Re-check eye Apneic spells in infants Vaginal pain / itch Near Drowning Working Group. Revision of the MOI
Canadian Emergency Department
Information System (CEDIS) presenting
complaint list version 1.1. CJEM Def.
Last slide 2008;10:151-61
viewed
Go to Title page
Go to Pediatric COT
Subst Mental ENT - Cardio OB- Gen- Environ Gene
ment
Skin
abuse Health other Vasc GYN Urin ral
Go to Adult COT
Substance Misuse (Subst) ENT – Nose CardiovascularMaster list Genitourinary (Gu) Skin (Skin)
PedIATRIC COT
Substance misuse / Intoxication Epistaxis Cardiac arrest (non traumatic) Flank pain Bite
Overdose ingestion Nasal congestion / Hay fever Cardiac arrest (traumatic) Hematuria Sting
Substance withdrawal Foreign body, nose Chest pain (cardiac features) Genital discharge / lesion Abrasion
URTI complaints Chest pain (non cardiac features) Penile swelling Laceration / Puncture
Mental health & psychosocial Nasal trauma Palpitations / Irregular heart beat Scrotal pain and/or swelling Burn
Depression / Suicidal / Deliberate self harm Hypertension Urinary retention Blood and body fluid exposure
Anxiety / Situational crisis General weakness UTI complaints Pruritus
Hallucinations / Delusions Syncope / Pre-syncope Oliguria Rash
ENT – Ears
Insomnia Edema, generalized Polyuria Localized swelling / redness
Violent / Homicidal behavior Earache
Bilateral leg swelling / Edema Genital trauma Wound check
Social problem Foreign body ear
Cool pulseless limb Other skin conditions
Bizarre behaviour Loss of hearing
Unilateral reddened hot limb Lumps, bumps, calluses
Concern for patient's welfare Tinnitus
Orthopedic (Ortho) Redness / tenderness, breast
Paediatric Disruptive behaviour Discharge, ear Gastrointestinal (GI)
Back pain Rule out infestation
Ear injury Abdominal pain
Traumatic back / spine injury Cyanosis
Anorexia Spontaneous bruising
Amputation
Constipation Foreign body, skin
Neurologic (Cns) Upper extremity pain
ENT – Mouth, Throat, Neck Diarrhea Removal staples / sutures
Altered level of consciousness Lower extremity pain
Dental / Gum problems Foreign body in rectum
Confusion Upper extremity injury
Facial trauma Groin pain / mass General & Minor (Gen)
Vertigo Lower extremity injury
Sore throat Vomiting and/or nausea Exposure to communicable disease
Headache Joint(s) swelling
Neck swelling / pain Rectal / Perineal pain Fever
Seizure Paediatric gait disorder / painful walk
Neck trauma Vomiting blood Hyperglycemia
Gait disturbance / Ataxia Cast check
Difficulty swallowing / Dysphagia Blood in stool / Melena Hypoglycemia
Head injury Jaundice Direct referral for consultation
Tremor
Facial pain (non-traumatic / non-dental) Ped
Hiccoughs Trauma (T) Dressing change mod
Extremity weakness / Symptoms of CVA Abdominal mass / distention
Major trauma – penetrating Imaging tests Critic
Sensory loss / Parasthesias Anal / Rectal trauma
Major trauma – blunt Medical device problem look
Floppy child Oral / Esophageal Foreign Body
Isolated chest trauma – penetrating Prescription / Medication request
Feeding difficulties in newborn Ring removal CNS
Isolated chest trauma – blunt
Neonatal jaundice Abnormal lab values
Ophthalmology (Ophth) Respiratory (Resp) Isolated abdominal trauma – penetrating
Pallor / Anemia Hemo
Chemical exposure, eye Shortness of breath Ob – Gyn (Ob - Gyn) Isolated abdominal trauma – blunt dyn
Foreign body, eye Respiratory arrest Menstrual problems Post-operative complications
Visual disturbance Cough / Congestion Foreign body, vagina Inconsolable crying in infants Resp
Eye pain Hyperventilation Vaginal discharge ENVIRONMENTAL Congenital problem in children
Red Eye, discharge Hemoptysis Sexual assault Frostbite / Cold injury Minor complaints NOS
Temp
Photophobia Respiratory foreign body Vaginal bleed Noxious inhalation Newly born
Diplopia Allergic reaction Labial swelling Electrical injury
Pain
Periorbital swelling Stridor Pregnancy issues < 20 wks Chemical exposure Reference: Grafstein E, Bullard MJ,
Eye trauma Wheezing – no other complaints Pregnancy issues > 20 wks Hypothermia Warren D, Unger B, the CTAS National
Re-check eye Apneic spells in infants Vaginal pain / itch Near Drowning Working Group. Revision of the BD
Canadian Emergency Department
Information System (CEDIS) presenting MOI
complaint list version 1.1. CJEM
Last slide 2008;10:151-61
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Colour schemes
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Vital Signs 1st order modifiers
Level of consciousness Bleeding Modifiers
1Modifiers
Unconscious (GCS 3-9) 2 Bleeding disorder (life or limb threatening bleed)
Adult
2 Altered level of consciousness (GCS 10 - 13) 3 Bleeding disorder (moderate or minor bleeds)
Hemodynamic Status Mechanism of Injury

1 Shock 2 High risk mechanism of injury
2 Hemodynamic compromise
3 Pulse rate/pressure abnormal (hemodynamically stable) Acute Central Pain
2 Acute central severe pain (8-10)
Respiratory Modifiers 3 Acute central moderate pain ( 4- 7)
1 Severe respiratory distress 4 Acute central mild pain ( < 4 )
2 Moderate respiratory distress Chronic Central Pain
3 Mild respiratory distress 3 Chronic central severe pain (8-10)
4 Chronic central moderate pain ( 4- 7) Mod
Adult
Temperature Modifiers* 5 Chronic central mild pain ( < 4 )
CNS
2 Fever, immunocompromised Acute Peripheral Pain
2 Looks septic (3 SIRS criteria) 3 Acute peripheral severe pain (8-10) Hemo
dyn
3 Fever (looks unwell), < 3 SIRS criteria 4 Acute peripheral moderate pain ( 4- 7)
Resp
4 Fever (appears well), 1 SIRS criterion (fever) 5 Acute peripheral mild pain ( < 4 )
* can be applied on a documented Hx of fever even if patient Chronic Peripheral Pain Temp
afebrile at triage 4 Chronic peripheral severe pain (8-10)
Pain
5 Chronic peripheral pain ( < 8 )
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Adults: Respiratory Modifiers
CTAS Level of Respiratory Distress O2 Sat PEFR
Level predicted
Severe: Fatigue from excessive work of

breathing, cyanosis, single-word speech, unable
1 to speak, upper airway obstruction, lethargic or
<90% -
confused.
Moderate: Increased work of breathing,

speaking phrases or clipped sentences,
2
Mod
<92% <40% Adult
significant or worsening stridor but airway CNS
protected. Hemo
dyn
Resp
Mild: Dyspnea, tachypnea, shortness of breath
on exertion, no obvious increased work of 92 - Temp
3 breathing, able to speak in sentences, stridor 94%

40 - 60% Pain
without any obvious airway obstruction. BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Adults: Hemodynamic Modifiers
CTAS Circulatory Status
Level
Shock: evidence of severe end-organ hypoperfusion: marked pallor,

cool skin, diaphoresis, weak or thready pulse, hypotension, postural
1 syncope, significant tachycardia or bradycardia, ineffective ventilation or
oxygenation, decreased level of consciousness. Could also appear as
flushed, febrile, toxic, as in septic shock.
Hemodynamic compromise: evidence of borderline perfusion;

pale, history of diaphoresis, unexplained tachycardia, postural Mod
Adult
2 hypotension (by history), feeling faint on sitting and standing, or

suspected hypotension (lower than normal blood pressure or expected
CNS
Hemo
blood pressure for a given patient) (hemodynamic compromise) dyn
Resp
Vital signs at the upper and lower ends of normal as they relate to the Temp
3 presenting complaint, especially if they differ from the usual values for
the specific patient
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Adults: Level of Consciousness
CTAS Level of Consciousness GCS
Level
Unconscious: unable to protect airway, response 3–9

to pain or loud noise only and without purpose,
1 continuous seizure or progressive deterioration in
level of consciousness
Altered level of consciousness: response 10 – 13

inappropriate to verbal stimuli; loss of orientation Mod
2 to person place or time; new impairment of recent
memory; altered behaviour
Adult
CNS
Hemo
dyn
Resp
Temp
GCS Pain
definitions BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Adults: Temperature / Sepsis
ADULT COT
CTAS
Level Fever >38. 0 C (age ≥17 years) SIRS is the systemic inflammatory response
to a variety of severe clinical insults.
The response is manifested by 2 or
Immunocompromised: neutropenia more of the following criteria:
(or suspected), chemotherapy or on
2 immunosupressive drugs including
-temperature >38°C or <36°C;
steroids. -heart rate >90 beats/minute;
-respiratory rate >20 breaths/minute or
Looks septic: has 3 positive SIRS PaCO2 <32 torr (<4.3 kPa);
criteria or hemodynamic compromise,
2 moderate respiratory distress or -WBC >12000 cells/mm3, <4000
cells/mm3 or >10% immature
altered level of consciousness. (band) forms.
Mod
Adult
CNS
Looks unwell: has < 3 positive SIRS Sepsis is defined as the systemic response
Hemo
to infection, manifested by 2 or more of
criteria but appears ill-looking dyn
3 (flushed, lethargic, anxious or
the SIRS criteria as a result of
infection. Resp
agitated. Temp
Severe sepsis is defined as sepsis
associated with organ dysfunction, Pain
Looks well: has fever as the only hypoperfusion or hypotension;
4 positive SIRS criterion and appears hypoperfusion and perfusion
abnormalities may include, but are not
BD
comfortable and in no distress. MOI

limited to, lactic acidosis, oliguria or an
acute alteration in mental status. Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Adults: Pain Severity Modifier
SEVERE 8 -10 2 Central pain originates within a body
cavity or organ and may be
ACUTE MODERATE 4-7 3 associated with life- or limb-
threatening conditions.
MILD <4 4 Peripheral pain originates in the skin,
soft tissues, axial skeleton or
CENTRAL superficial organs where dangerous
SEVERE 8 -10 3 diagnoses are less likely to be
missed. *Caveat: A patient presenting
with apparent peripheral pain in whom
CHRONIC MODERATE 4-7 4 the triage nurse suspects a life or limb
threatening condition should score
MILD <4 5 based on “central” pain.
Mod
Acute pain is a new onset pain and is Adult
8 -10 more likely to prove dangerous (prior
SEVERE 3 CNS
to a diagnostic work-up) than chronic
pain. Hemo
dyn
ACUTE MODERATE 4-7 4
Chronic pain is a well-recognized Resp
MILD <4 5 continuing or recurring pain syndrome Temp
PERIPHERAL manifesting the same pattern
(changes in pattern or severity = Pain
SEVERE 8 -10 4 acute).
BD
CHRONIC
MOI
MILD / MOD <8 5
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Adults: Bleeding disorder (congenital or acquired)
Life or Limb Threatening Moderate/Minor
CTAS level 2 CTAS level 3
Head (intracranial) & neck Nose (epistaxis)
Chest,abdomen,pelvis,spine Mouth (including gums)
Massive vaginal hemorrhage Joints (hemarthroses)
Iliopsoas muscle & hip Menorrhagia

Mod
Adult
Extremity muscle compartments Abrasions CNS
Hemo
dyn
Fractures & dislocations Superficial lacerations
Resp
Deep lacerations Temp
Pain
Any uncontrolled bleeding
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Adults: Mechanism of Injury
MOI CTAS Level 2
General MVC: Ejection from vehicle, rollover, extrication time>20 minutes, significant
Trauma intrusion into passenger’s space, death in the same passenger compartment, impact
>40 km/h (unrestrained) or impact>60 km/h (restrained)
MCC: Where impact with a car>30 km/hr, especially if rider is separated from
motorcycle
Pedestrian or bicyclist Run over or struck by vehicle at >10 km/h
Fall: of >18 ft (>6 m) or 5 stairs
Penetrating injury: To head, neck, torso or extremities prox to elbow and knee
Head MVC: ejection from vehicle, unrestrained passenger striking head on windshield Mod
Trauma Pedestrian: struck by vehicle Adult
Fall: from >3 ft (>1 m) or 5 stairs CNS
Assault: With blunt object other than fist or feet Hemo
dyn
Neck MVC: ejection from vehicle, rollover, high speed (esp. if driver unrestrained) Resp
Trauma MCC: impact with a car > 30 km/hr, especially if rider is separated from motorcycle
Temp
Fall: from >3 ft (>1 m) or 5 stairs
Axial load to the head Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Def: suicidality, anxiety, agitation
Suicidal Term Definition Anxiety / Definition
Agitation
Suicide Self injurious behavior with a non fatal Severe Extreme unease,
attempt outcome accompanied by evidence (explicit anxiety / apprehension or worry with
or implicit) that the person attempted to die. signs of tachycardia or
agitation
agitation; or dangerously
Suicide intent Subjective expectation and desire for self- agitated and uncooperative
destructive act that would end in death. and does not calm down when
asked
Suicidal Thought of serving as an agent of one’s
ideation own death, may vary in seriousness Moderate Clear unease, apprehension,
depending on specificity of plans and anxiety / or worry, but no obvious
degree of suicidal intent. tachycardia or tremulousness;
agitation
or signs of agitation, and does Mod
Adult
Uncertain flight Patients threatening violence towards not consistently obey
or safety risk themselves or others; patients exhibiting commands (e.g. will sit or CNS
uncontrolled anger, restlessness, paranoia, calm down when asked, but Hemo
or hallucinatory behavior; or patients unable soon becomes restless and dyn
or unwilling to cooperate with suicide risk agitated again Resp
assessment and who pose a flight risk.
Need close observation based on site Temp
resources. Mild anxiety Mild unease, apprehension or Pain
(If family member willing to observe & both / agitation worry, but can be reassured;
parties agree ‘hospital-assigned’ close or restless but cooperative; BD
observation may not be required.) obeys commands.
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Def: Psychosis, paranoia, hallucinations, chronic, Bizarre behaviour
Hallucination / Definition Bizarre Definition

Delusion Behavior
Acute May present with extreme self neglect, Uncontrolled Bizarre, disoriented or
psychosis disordered or racing thoughts or both, irrational behavior, not
speech pattern impairments, impaired reality controlled by verbal
testing with ‘lack of insight’, may be communication and
responding to hallucinatory or delusional reasoning, and placing the
thoughts or both, which may be patient or others in physical
accompanied by hostility. danger
Paranoia Delusions of a persecutory nature - being Controlled Bizarre, irrational behavior

followed, poisoned, or harmed in some way. that is viewed as threatening
Ideas of reference - the belief that people but controllable through
Mod
are talking about you. May be accompanied verbal support and reasoning; Adult
by extreme fear, agitation or hostility. patient is accompanied by a
CNS
friend or family member.
Hemo
Chronic Known history of hallucinations with no dyn
hallucination recent change in nature, and/or frequency,
or in patient’s level of distress related to Harmless Bizarre or eccentric behavior Resp
s behavior (usually of long standing with
them. Temp
no recent change from
Chronic, Patient is well known to the ED and triage patient’s norm) that is of no Pain
non-urgent nurse with a recurrent complaint that has threat to the patient or others
either been fully dealt with, or patient is just and requires no acute BD
condition looking for food, warmth or temporary intervention.
MOI
shelter.
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Substance misuse
ADULT COT
Substance misuse / Intoxication
Overdose ingestion
Mod
Adult
CNS
Substance withdrawal Hemo

dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Mental health and psychosocial issues
ADULT COT
Anxiety / Situational crisis Social problem
Hallucinations / Delusions Bizarre behaviour
Insomnia Concern for patient's welfare
Violent / Homicidal behaviour Pediatric Disruptive behaviour

Mod
Adult
Depression / Suicidal / CNS
Deliberate self harm Hemo

dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Neurologic
ADULT COT
Altered level of Extremity weakness /
consciousness Symptoms of CVA
Confusion Head injury
Vertigo Tremor
Mod
Headache Sensory loss / Parasthesias Adult
CNS
Hemo
dyn
Seizure Floppy child Resp
Temp
Gait disturbance / Ataxia Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Ophthalmology
ADULT COT
Chemical exposure, eye Photophobia
Foreign body, eye Diplopia
Visual disturbance Periorbital swelling
Eye pain Eye trauma Mod

Adult
CNS
Red Eye, discharge Re-check eye Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Ent-nose
ADULT COT
Epistaxis
Nasal congestion / Hay fever
Foreign body, nose
URTI complaints Mod

Adult
CNS
Nasal trauma Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ENT- Ears
ADULT COT
Earache
Foreign body ear
Loss of hearing
Tinnitus Mod
Adult
CNS
Discharge, ear Hemo
dyn
Resp
Ear injury Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ENT – Mouth, Throat, Neck
ADULT COT
Dental / Gum problems
Facial trauma
Sore throat
Neck swelling / pain Mod

Adult
CNS
Hemo
Neck trauma dyn
Resp
Temp
Difficulty swallowing / Dysphagia
Pain
BD
Facial pain (non-traumatic / non-dental) MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Respiratory
ADULT COT
Shortness of breath Respiratory foreign body
Respiratory arrest Allergic reaction
Hyperventilation Stridor
Hemoptysis Apneic spells in infants Mod

Adult
Cough / Congestion Wheezing – no other

CNS
Hemo
complaints dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Cardiovascular
ADULT COT
Cardiac arrest (non traumatic) General weakness
Cardiac arrest (traumatic) Syncope / Pre-syncope
Chest pain (cardiac features) Edema, generalized
Chest pain (non cardiac features) Bilateral leg swelling / Edema Mod
Adult
CNS
Palpitations / Irregular heart beat Cool pulseless limb Hemo
dyn
Resp
Hypertension Unilateral reddened hot limb Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Gastrointestinal
ADULT COT
Abdominal pain Vomiting blood
Anorexia Blood in stool / Melena
Constipation Jaundice
Foreign body in rectum Hiccoughs
Groin pain / mass Abdominal mass / distention Mod

Adult
CNS
Vomiting and/or nausea Anal / Rectal trauma Hemo
dyn
Resp
Rectal / Perineal pain Oral / Esophageal Foreign
Temp
Diarrhea Feeding difficulties in newborn Pain
BD
Neonatal jaundice MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Obstetrics-gynecology
ADULT COT
Menstrual problems Vaginal bleed
Foreign body, vagina Labial swelling
Vaginal discharge Pregnancy issues < 20 wks
Vaginal pain / itch Pregnancy issues > 20 wks Mod

Adult
CNS
Sexual assault Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Genito-urinary
ADULT COT
Flank pain Urinary retention
Hematuria UTI complaints
Genital discharge / lesion Oliguria
Penile swelling Polyuria Mod

Adult
CNS
Scrotal pain and/or swelling Genital trauma Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Orthopedic
ADULT COT
Back pain Upper extremity injury
Traumatic back / spine injury Lower extremity injury
Amputation Joint(s) swelling
Upper extremity pain Cast check Mod

Adult
Lower extremity pain Pediatric gait disorder / CNS

Hemo
painful walk dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Trauma
ADULT COT
Major trauma – penetrating
Major trauma – blunt
Isolated chest trauma – penetrating

Mod
Isolated chest trauma – blunt Adult
CNS
Hemo
dyn
Resp
Isolated abdominal trauma – penetrating Temp
Pain
Isolated abdominal trauma – blunt BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Environmental
ADULT COT
Frostbite / Cold injury
Noxious inhalation
Electrical injury
Chemical exposure Mod

Adult
CNS
Hypothermia Hemo
dyn
Resp
Near Drowning Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Skin
ADULT COT
Bite Rash
Sting Redness / tenderness, breast
Abrasion Localized swelling / redness
Laceration / Puncture Lumps, bumps, calluses
Burn Rule out infestation Mod
Adult
CNS
Blood and body fluid exposure Cyanosis Hemo
dyn
Foreign body, skin Spontaneous bruising Resp
Temp
Wound check Pruritis Pain
BD
Removal staples / sutures Other skin conditions MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
General & Minor
ADULT COT
Exposure to communicable disease Prescription / Medication request
Fever Ring removal
Hyperglycemia Abnormal lab values
Hypoglycemia Pallor / anemia
Direct referral for consultation Post-operative complications

Mod
Adult
Dressing change Inconsolable crying in infants CNS

Hemo
dyn
Imaging tests Congenital problem in children Resp
Temp
Medical device problem Minor complaints NOS Pain
BD
Newly born MOI
Def.
Last slide
viewed *NOS: not otherwise specified
Go to Pediatric COT
ment
Skin
Go to Adult COT
Cardi
ADULT COT
ac
system
Coding
NACRS Code 001 Cardiac arrest (non traumatic) arrest

(non
traum
atic)
Cardiac arrest
1
(non-traumatic)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 002 Cardiac arrest (traumatic)

Cardi
ac
arrest Cardiac arrest
1
(trau
matic) (traumatic)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 003 Chest pain (cardiac features)

Chest
pain
(cardi
ae
1 VS
ac
featur 1
Vital sign modifiers
Severe respiratory distress
es)
1 Shock
Chest Pain with cardiac 1 Unconscious (GCS 3-9)
2 2 Moderate respiratory distress
features 2 Hemodynamic compromise
2 Altered level of consciousness (GCS 10 - 13)
2 Fever, immunocompromised
2 Looks septic (3 SIRS criteria)
Other 1st order modifiers
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Chest
ADULT COT
pain
system
Coding
NACRS Code 004 Chest pain (non cardiac features) (non

cardia
c
featur
es)
ae
1 VS Vital sign modifiers
1 Severe respiratory distress
1 Shock
2 VS, PSC 1 Unconscious (GCS 3-9)
2 Moderate respiratory distress
Other significant chest pain 2 Hemodynamic compromise
2 2 Altered level of consciousness (GCS 10 - 13)
(ripping, tearing) 2 Fever, immunocompromised
3 VS, PSC, PSP, chronicity 3 Mild respiratory distress
3 Pulse rate/pressure abnormal (hemodynamically stable)
3 Fever (looks unwell), < 3 SIRS criteria
4 VS, PSC, PSP, chronicity 4 Fever (appears well), 1 SIRS criteria (fever) Mod
Other 1st order modifiers Adult
5 Chest pain, non cardiac 2

3
Acute central severe pain (8-10)
Acute central moderate pain ( 4- 7)
CNS
Hemo
3 Acute peripheral severe pain (8-10) dyn
3 Chronic central severe pain (8-10) Resp
4 Acute central mild pain ( < 4 )
Note with chest wall pain the 4 Acute peripheral moderate pain ( 4- 7) Temp
pain is peripheral 4 Chronic central moderate pain ( 4- 7)
Pain
4 Chronic peripheral severe pain (8-10)
5 Chronic central mild pain ( < 4 ) BD
5 Acute peripheral mild pain ( < 4 )
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Palpit
ADULT COT
ations
system
Coding
NACRS Code 005 Palpitations / Irregular heart beat /

Irregu
lar
heart
beat
ae
1 VS Vital sign modifiers
2 VS 1 Shock
1 Unconscious (GCS 3-9)
With chest pain cardiac
2 2 Hemodynamic compromise
features 2 Altered level of consciousness (GCS 10 - 13)
History or documented 2 Looks septic (3 SIRS criteria)
3 Mild respiratory distress
2 evidence of potential lethal 3 Pulse rate/pressure abnormal (hemodynamically stable)
dysrhythmia 3 Fever (looks unwell), < 3 SIRS criteria
Mod
Adult
3 VS CNS
Hemo
dyn
3 Acute onset, ongoing Resp
History of palpitations, Temp

4
presently resolved Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 006 Hypertension

Hyper ae
1
tensio
n
VS Vital sign modifiers
2 VS 1 Shock
HTN (SBP >= 220 or DBP >= 130)
2 with symptoms+ any of (SOB, chest
pain, confusion, sudden HA, N/V) 2 Fever, immunocompromised
3 VS 3 Mild respiratory distress
HTN (SBP >= 220 or DBP >= 130)
3 with no other presenting symptoms
Mod
Adult
CNS
HTN (SBP 200-220 and DBP 110-
3 130) with hypertensive symptoms Hemo
dyn
HTN (SBP 200-220 and DBP 110- Resp

4 130) with no symptoms Temp
Pain
SBP=SYSTOLIC BLOOD PRESSURE
DBP=DIASTOLIC BLOOD PRESSURE BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
Gener
system
Coding
007 General weakness

al
NACRS Code weak
ness
ae
1 VS, Severe dehydration Vital sign modifiers
2 VS, Moderate dehydration 1 Shock
VS, Acute inability to
ambulate 2 Hemodynamic compromise
3 Mild dehydration 2 Fever, immunocompromised
4 VS, Potential for dehydration 3 Mild respiratory distress
4 Chronic weakness 3 Fever (looks unwell), < 3 SIRS criteria
4 Fever (appears well), 1 SIRS criteria (fever) Mod
Adult
CNS
Hemo
dyn
Resp
If considering a CVA go to:
Temp
Symptoms of a CVA
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 008 Syncope / Pre-syncope

Synco
pe /
1
Pre- VS ae
synco
2
pe VS 1 Severe respiratory distress
1 Shock
New onset dysrhythmia, 1 Unconscious (GCS 3-9)
2 irregular pulse &/or change in 2 Moderate respiratory distress
rate 2 Hemodynamic compromise
2 No prodromal symptoms 2 Fever, immunocompromised
2 Occurring during exercise 3 Mild respiratory distress
3 VS 3 Fever (looks unwell), < 3 SIRS criteria Mod
Adult
With prodromal symptoms or
3 sudden position change
CNS
Hemo
dyn
Normal vitals, symptoms
4 resolved
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 009 Edema, generalized

Edem
ae
1a,
gener
alized 1 Severe respiratory distress
2 VS 1 Shock
3 VS 2 Moderate respiratory distress
Edema, generalized, normal
vitals 2 Fever, immunocompromised
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 010 Bilateral leg swelling / Edema

Bilate
ral leg
ae
2
swelli
ng /
Edem 2 Moderate respiratory distress
3a VS, PSP 2 Hemodynamic compromise
4 VS, PSP + chronicity 2 Fever, immunocompromised
Edema/bilateral leg 3 Mild respiratory distress
5
swelling, chronic 3 Pulse rate/pressure abnormal (hemodynamically stable)
4 Fever (appears well), 1 SIRS criteria (fever)
3 Acute peripheral severe pain (8-10)
4 Acute peripheral moderate pain ( 4- 7) Mod
Adult
5 Acute peripheral mild pain ( < 4 ) CNS
5 Chronic peripheral pain ( < 8 ) Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 011 Cool pulseless limb

Cool
ae
1
pulsel
ess
limb 1 Severe respiratory distress
2 Cool Pulseless Limb 1 Shock
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 012 Unilateral reddened hot limb

Unilat
eral
ae
2
redde
ned
hot 2 Moderate respiratory distress
3
limb VS, PSP 2 Hemodynamic compromise
3 Extensive inflammation 2 Fever, immunocompromised
4 Localized inflammation 3 Mild respiratory distress
Mod
4 Acute peripheral moderate pain ( 4- 7) Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 051 Earache

ae
3
Earac
he
VS, PSP Vital sign modifiers
4 VS, PSP, + chronicity 3 Pulse rate/pressure abnormal (hemodynamically stable)
5 Earache with mild pain 4 Fever (appears well), 1 SIRS criteria (fever)
4 Acute peripheral moderate pain ( 4- 7)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 052 Foreign body ear

Forei
ae
gn
Acute peripheral severe
3
body 3 Acute peripheral severe pain (8-10)
ear pain (8-10) 4 Acute peripheral moderate pain ( 4- 7)
Acute peripheral moderate
4
pain ( 4- 7)
Foreign body ear, mild pain
5
(<4)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 053 Loss of hearing

Loss
3of
hearin
Hearing loss, sudden onset
g
5 Hearing loss, gradual onset
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 054 Tinnitus

Tinnit
Suspected aspirin
2
us
ingestion
4 Tinnitus
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 055 Discharge, ear

Disch ae
3
arge, VS Vital sign modifiers
ear
4 VS 3 Pulse rate/pressure abnormal (hemodynamically stable)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 056 Ear injury

ae
2
Ear
injury
2 Amputation 2 Hemodynamic compromise
3 VS, PSP, BD 2 Fever, immunocompromised
Cold injury severe with 3 Mild respiratory distress
3
blanching, cyanosis 3 Pulse rate/pressure abnormal (hemodynamically stable)
4 VS, PSP 4 Fever (appears well), 1 SIRS criteria (fever)
Cold injury, minor with no 3 Acute peripheral severe pain (8-10)
4 3 Bleeding disorder (moderate or minor bleeds) Mod
discoloration 4 Acute peripheral moderate pain ( 4- 7)
Adult

Laceration requiring Hemo
4 dyn
sutures Resp
Laceration/abrasion not Temp

5
requiring sutures Pain
BD
5 PSP
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 101 Dental / Gum problems

Denta
l/ ae
Gum
Dental avulsion (recent with 3 Acute peripheral severe pain (8-10)
2
proble
ms intact tooth present) 3 Bleeding disorder (moderate or minor bleeds)
3 PSP + BD 5 Acute peripheral mild pain ( < 4 )
4 PSP + chronicity
Dental/gum problem minor
5
problem
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 102 Facial trauma

Facial ae
1
traum VS Vital sign modifiers
a
2 VS, MOI 1 Shock
3 VS, PSP, BD 2 Moderate respiratory distress
4 VS, PSP 2 Altered level of consciousness (GCS 10 - 13)
Adult
2 High risk mechanism of injury CNS
3 Acute peripheral severe pain (8-10) Hemo
dyn
3 Bleeding disorder (moderate or minor bleeds)
4 Acute peripheral moderate pain ( 4- 7) Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 103 Sore throat

ae
1
Sore
throat
2 VS, PSC 1 Shock
2 Drooling or stridor 2 Moderate respiratory distress
Obvious edema/swelling of
lips, tongue or oropharynx 2 Fever, immunocompromised
3 VS, PSC 3 Mild respiratory distress
3 Difficulty swallowing 3 Fever (looks unwell), < 3 SIRS criteria
Adult
4 VS, PSC, chronicity Other 1st order modifiers
CNS
Minor sore throat +/- 3 Acute central moderate pain ( 4- 7) Hemo
5 3 Chronic central severe pain (8-10)
dyn
laryngitis 4 Acute central mild pain ( < 4 ) Resp
4 Chronic central moderate pain ( 4- 7) Temp

5 Chronic central mild pain ( < 4 )
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 104 Neck swelling / pain

Neck
ae
1
swelli
ng /
pain
2 VS, PSC 1 Shock
Neck stiffness /
meningismus +/- fever 2 Hemodynamic compromise
3 VS, PSC 2 Fever, immunocompromised
4 VS, PSC, chronicity 3 Mild respiratory distress
Neck swelling/pain with 3
4
Fever (looks unwell), < 3 SIRS criteria
Fever (appears well), 1 SIRS criteria (fever) Mod
5 chronic central mild pain Other 1st order modifiers
Adult
CNS
(< 4) 2 Acute central severe pain (8-10)
Hemo
3 Acute central moderate pain ( 4- 7) dyn
3 Chronic central severe pain (8-10)
Resp
4 Chronic central moderate pain ( 4- 7) Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 105 Neck trauma

Neck
1
traum VS ae
a
2 VS, PSC, BD 1
1
Shock
Paresthesias, neurological
signs 2 Hemodynamic compromise
2 Hoarseness and dysphasia 2 Fever, immunocompromised
3 VS, PSC, BD 3
3
Mild respiratory distress
Pulse rate/pressure abnormal (hemodynamically stable)
4 VS, PSC, 3
4
Fever (appears well), 1 SIRS criteria (fever) Mod
Adult
CNS
2 Bleeding disorder (life or limb threatening bleed) Hemo
dyn
2 High risk mechanism of injury
Resp
3 Acute central moderate pain ( 4- 7)
3 Bleeding disorder (moderate or minor bleeds) Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 106 Difficulty swallowing / Dysphagia

Difficu
lty
ae
1
swallo
wing /
Dysp 1 Severe respiratory distress
2
hagia VS, PSC 1 Shock
3 Possible foreign body 2 Altered level of consciousness (GCS 10 - 13)
3 VS, PSC 2 Looks septic (3 SIRS criteria)
Other 1st order modifiers Mod
2 Acute central severe pain (8-10) Adult
3 Acute central moderate pain ( 4- 7) CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 107 Facial pain (non-traumatic / non-dental)

Facial
pain
(non-
ae
2
traum
atic /
non- 2 Moderate respiratory distress
3
dental VS, PSP, chronicity 2 Hemodynamic compromise
)
4 VS, PSP, chronicity 2 Fever, immunocompromised
5 PSP, chronicity 3 Mild respiratory distress
4 Acute peripheral moderate pain ( 4- 7) Mod
Adult
5 Chronic peripheral pain ( < 8 ) Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 151 Epistaxis

ae
1
Epista
xis
2 VS, BD 1 Shock
2 Uncontrolled epistaxis 2 Moderate respiratory distress
(despite appropriate pressure) 2 Hemodynamic compromise
3 VS, BD 2 Fever, immunocompromised
Bleeding controlled with
3 3 Mild respiratory distress
pressure 3 Pulse rate/pressure abnormal (hemodynamically stable)
4 VS 4 Fever (appears well), 1 SIRS criteria (fever)
Mod
Adult
Other 1st order modifiers CNS
Acute epistaxis, no active 2 Bleeding disorder (life or limb threatening bleed)
4 Hemo
bleeding 3 Bleeding disorder (moderate or minor bleeds) dyn
Resp
Periodic / recurrent, no
5 Temp
active bleeding Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 152 Nasal congestion / Hay fever

Nasal
conge
stion / Nasal congestion / hay
5Hay
fever fever
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 153 Foreign body, nose
Moderate respiratory
Foreign body,
ae
2 nose Vital sign modifiers
distress 2 Moderate respiratory distress
3 VS, PSP 3 Pulse rate/pressure abnormal (hemodynamically stable)
Foreign body, nose with 3 Acute peripheral severe pain (8-10)
5 4 Acute peripheral moderate pain ( 4- 7)
acute peripheral mild pain 5 Acute peripheral mild pain ( < 4 )
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 154 URTI complaints

URTI ae
2
compl VS Vital sign modifiers
aints
3 VS, PSP 3 Mild respiratory distress
4 VS, PSP 3 Fever (looks unwell), < 3 SIRS criteria
5 Appears well, no fever Other 1st order modifiers
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 155 Nasal trauma

Nasal ae
2
traum VS, BD Vital sign modifiers
a
Uncontrolled epistaxis 2 Hemodynamic compromise
2 (despite appropriate 2 Altered level of consciousness (GCS 10 - 13)
pressure) 2 Fever, immunocompromised
3 VS, PSP, BD 3 Mild respiratory distress
4 VS, PSP 3 Fever (looks unwell), < 3 SIRS criteria
5 PSP Other 1st order modifiers
2 Bleeding disorder (life or limb threatening bleed)
Mod
3 Acute peripheral severe pain (8-10) Adult
3 Bleeding disorder (moderate or minor bleeds) CNS
4 Acute peripheral moderate pain ( 4- 7) Hemo
5 Acute peripheral mild pain ( < 4 ) dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 201 Frostbite / Cold injury

ae
2Frostbite
Cold/ pulseless limb 3 Acute peripheral severe pain (8-10)
Cold injury
3 PSP 4
4
Acute peripheral moderate pain ( 4- 7)
Chronic peripheral severe pain (8-10)
3 Blanching of skin 5 Acute peripheral mild pain ( < 4 )
4 PSP, chronicity
5 Frostbite/cold injury
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 202 Noxious inhalation

Noxio
ae
1 us
inhala
tion
2 VS 1 Severe respiratory distress
1 Shock
3 VS 1 Unconscious (GCS 3-9)
Smoke inhalation, or other, 2 Hemodynamic compromise
3
no distress 2 Altered level of consciousness (GCS 10 - 13)
Remote exposure, no 3 Pulse rate/pressure abnormal (hemodynamically stable)
4
symptoms
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 203 Electrical injury

Electri ae
1cal VS Vital sign modifiers
injury
2 VS 1 Shock
2 Obvious cutaneous injury 2 Moderate respiratory distress
3 VS, PS 2
2
Hemodynamic compromise
Altered level of consciousness (GCS 10 - 13)
No obvious cutaneous 3 Mild respiratory distress
3 3 Pulse rate/pressure abnormal (hemodynamically stable)
injury Other 1st order modifiers
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 204 Chemical exposure

Chem
ae
1
ical
expos
ure 1 Severe respiratory distress
1 Major burn >25% BSA 1 Shock
Major burn hand, feet,
groin or face 2 Hemodynamic compromise
2 Symptomatic eye 'splash'
Mod
Adult
The minimum level is 2 to BSA estimation CNS
ensure early decontamination Hemo
dyn
and identification of the Resp
substances as toxic or not Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 205 Hypothermia

Hypot ae
1
hermi VS Vital sign modifiers
a
2 VS 1 Shock
Hypothermia, Core 1 Unconscious (GCS 3-9)
temperature < 32 °C 2 Hemodynamic compromise
3 VS 2 Fever, immunocompromised
3 Core temperature 32-35 °C 3 Mild respiratory distress
4 No frostbite, normal VS 3 Fever (looks unwell), < 3 SIRS criteria Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 206 Near Drowning

Near ae
1
Drow VS Vital sign modifiers
ning
2 VS 1 Shock
Hypothermia, Core
3 Core temperature 32-35 °C 3 Mild respiratory distress
3 Fever (looks unwell), < 3 SIRS criteria Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 251 Abdominal pain

Abdo ae
1
minal VS Vital sign modifiers
pain
2 VS, PSC 1 Shock
3 VS, PSC, chronicity 1 Unconscious (GCS 3-9)
4 VS, PSC, chronicity 2 Hemodynamic compromise
Chronic mild abdominal 2 Fever, immunocompromised
5 2 Looks septic (3 SIRS criteria)
pain 3 Mild respiratory distress
4 Fever (appears well), 1 SIRS criteria (fever) Adult
2 Acute central severe pain (8-10) Hemo

Temp
4 Chronic central moderate pain ( 4- 7)
5 Chronic central mild pain ( < 4 ) Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 252 Anorexia
2
Anore
xia
VS ae
3 Significant weight loss 2 Altered level of consciousness (GCS 10 - 13)
4 Anorexia, looks well 2 Looks septic (3 SIRS criteria)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 253 Constipation

Const
2
ipatio VS, PSC ae
n
3 VS, PSC, chronicity 2 Moderate respiratory distress
4 VS, PSC, chronicity 2 Altered level of consciousness (GCS 10 - 13)
5 Simple constipation 2 Looks septic (3 SIRS criteria)
2 Acute central severe pain (8-10) Mod
3 Acute central moderate pain ( 4- 7) Adult
3 Chronic central severe pain (8-10) CNS

4 Acute central mild pain ( < 4 ) Hemo
dyn
5 Chronic central mild pain ( < 4 ) Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 254 Diarrhea

ae
1
Diarrh
ea
VS, severe dehydration Vital sign modifiers
2 VS, moderate dehydration 1 Severe respiratory distress
1 Shock
Uncontrolled bloody 1 Unconscious (GCS 3-9)
3
diarrhea 2 Moderate respiratory distress
3 VS, Mild dehydration 2 Altered level of consciousness (GCS 10 - 13)
4 VS 2 Looks septic (3 SIRS criteria)
Chronic diarrhea, normal 3 Mild respiratory distress
5 3 Pulse rate/pressure abnormal (hemodynamically stable)
VS 3 Fever (looks unwell), < 3 SIRS criteria
Mod
Adult
4 Fever (appears well), 1 SIRS criteria (fever) CNS
Hemo
dyn
Resp
If a BD exist with presence of bloody
Temp
diarrhea then go to
Pain
Blood in stool/melena
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 255 Foreign body in rectum

Forei
gn
2
body
in
VS ae
rectu
3m VS, PSP 2 Moderate respiratory distress
5 Foreign body in rectum 2 Looks septic (3 SIRS criteria)
Mod
4 Acute peripheral moderate pain ( 4- 7) CNS
5 Acute peripheral mild pain ( < 4 ) Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 256 Groin pain / mass

Groin ae
2
pain / VS, PSC Vital sign modifiers
mass
4 VS, PSC, chronicity 2 Fever, immunocompromised
5 Groin pain / mass 2
3
Looks septic (3 SIRS criteria)
Mild respiratory distress
Mod
Hemo
4 Chronic central moderate pain ( 4- 7) dyn
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 257 Vomiting and/or nausea

Vomit
ing
ae
1
and/o
r
naus
Active significant 1 Severe respiratory distress
2ea
1 Shock
hematemesis 1 Unconscious (GCS 3-9)
2 VS, moderate dehydration 2 Hemodynamic compromise
Coffee ground emesis / 2 Altered level of consciousness (GCS 10 - 13)
3 2 Fever, immunocompromised
melena 2 Looks septic (3 SIRS criteria)
3 VS, mild dehydration 3 Pulse rate/pressure abnormal (hemodynamically stable)
VS, potential for Mod
4 4 Fever (appears well), 1 SIRS criteria (fever) Adult
dehydration CNS
Chronic vomiting and/or Hemo

5 dyn
nausea, normal VS Resp
Temp
Pain
If a BD exist with presence of
Coffee ground emesis / melena go to BD
“Vomiting blood” MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 258 Rectal / Perineal pain

Recta
l/ ae
2
Perin VS, PSP Vital sign modifiers
eal
3
pain
VS, PSP, chronicity 2 Hemodynamic compromise
4 VS, PSP, chronicity 2 Altered level of consciousness (GCS 10 - 13)
Chronic mild 2 Looks septic (3 SIRS criteria)
rectal/perineal pain 3 Pulse rate/pressure abnormal (hemodynamically stable)
3 Acute peripheral severe pain (8-10) Mod
4 Chronic peripheral severe pain (8-10) CNS
5 Chronic peripheral pain ( < 8 ) dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 259 Vomiting blood

Vomit ae
1
ing VS Vital sign modifiers
blood
2 VS 1 Shock
Active or significant
hematemesis 2 Hemodynamic compromise
Coffee ground 2 Fever, immunocompromised
3
emesis/melena 2 Looks septic (3 SIRS criteria)
Small amount, normal vital 3 Pulse rate/pressure abnormal (hemodynamically stable)
3 3 Fever (looks unwell), < 3 SIRS criteria
signs Other 1st order modifiers
Mod
Adult
2 Bleeding disorder (life or limb threatening bleed) CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 260 Blood in stool / Melena

Blood
in
ae
1
stool
/
Melen 1 Severe respiratory distress
2 a VS 1 Shock
Large amount of melena or
rectal bleeding 2 Hemodynamic compromise
Moderate amount of 3 Mild respiratory distress
3
melena or rectal bleeding 3
3
Mod
Rectal bleeding small Adult
4 Other 1st order modifiers
amount 2 Bleeding disorder (life or limb threatening bleed)
CNS
Hemo
3 Bleeding disorder (moderate or minor bleeds) dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 261 Jaundice

ae
2
Jaun
dice
VS, PSC Vital sign modifiers
5 Jaundice, looks well 3 Mild respiratory distress
3 Acute central moderate pain ( 4- 7) Mod
Adult
CNS
4 Chronic central moderate pain ( 4- 7) Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 262 Hiccoughs

Hicco
Fever (appears unwell), ae
3
ughs Vital sign modifiers
PSP 3 Fever (looks unwell), < 3 SIRS criteria
4 Fever (appears well), PSP Other 1st order modifiers
Hiccoughs, chronic no
distress 5 Acute peripheral mild pain ( < 4 )
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 263 Abdominal mass / distention

Abdo
minal
1
mass
/
VS ae
diste
2
ntion VS, PSC 1 Severe respiratory distress
1 Shock
3 Persistent vomiting 2 Hemodynamic compromise
Chronic abdominal 3 Mild respiratory distress
5
mass/distention, looks well 3 Pulse rate/pressure abnormal (hemodynamically stable)
Adult
dyn
4 Acute central mild pain ( < 4 ) Temp
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 264 Anal / Rectal trauma

Anal /
Recta ae
2 l VS, PSC, BD Vital sign modifiers
traum
3 a
VS, PSC, BD 2 Hemodynamic compromise
5 Anal/rectal trauma 2 Looks septic (3 SIRS criteria)
Mod
2 Bleeding disorder (life or limb threatening bleed) Adult
3 Bleeding disorder (moderate or minor bleeds) Hemo
Patients in shock from rectal 4 Acute central mild pain ( < 4 ) dyn
trauma should be Resp
documented under Temp
“Major trauma-penetrating Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 265 Oral / Esophageal Foreign Body

Oral /
Esop
hage
1
al VS ae
Forei Vital sign modifiers
2
gn
Body
Drooling or stridor 1 Severe respiratory distress
1 Shock
2 Hoarseness and dysphasia 1 Unconscious (GCS 3-9)
2 VS, PSC 2 Hemodynamic compromise
3 Persistent vomiting 3 Mild respiratory distress
4 VS, PSC 3 Pulse rate/pressure abnormal (hemodynamically stable)
No swallowing or 4 Fever (appears well), 1 SIRS criteria (fever) Adult
respiratory difficulty 2 Acute central severe pain (8-10)
CNS
Hemo
dyn
4 Acute central mild pain ( < 4 ) Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 601 Feeding difficulties in newborn

Feedi
ng
diffic
ulties
in
newb
orn
Peds specific
go to pediatric COT
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 602 Neonatal jaundice

Neon
atal
jaund
ice
Peds specific
go to pediatric COT
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 301 Flank pain

ae
1
Flank
pain
2 VS, PSC 1 Severe respiratory distress
1 Shock
5 Chronic mild flank pain 2 Fever, immunocompromised
Temp
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 302 Hematuria

ae
1
Hema
turia
2 VS, PSC, BD 1 Shock
VS, PSC, PSP, BD, 2 Moderate respiratory distress
chronicity 2 Altered level of consciousness (GCS 10 - 13)
4 VS, PSC, PSP, chronicity 2 Looks septic (3 SIRS criteria)
Chronic mild central or 3
3
5 moderate to mild 4 Fever (appears well), 1 SIRS criteria (fever)
peripheral pain 2
Acute central severe pain (8-10)
Mod
Adult
Hemo
3 Acute peripheral severe pain (8-10) dyn
3 Bleeding disorder (moderate or minor bleeds) Resp
4 Chronic central moderate pain ( 4- 7) Pain
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 303 Genital discharge / lesion

Genit
al
ae
3
disch
arge /
VS, PSP, chronicity Vital sign modifiers
lesio 3 Mild respiratory distress
4n VS, PSP, chronicity 3 Pulse rate/pressure abnormal (hemodynamically stable)
5 Genital discharge / lesion 4 Fever (appears well), 1 SIRS criteria (fever)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 304 Penile swelling

Penil
ae
2e
swelli
Priapism Vital sign modifiers
ng
Paraphimosis (retracted 2 Moderate respiratory distress
foreskin, unable to reduce) 2 Altered level of consciousness (GCS 10 - 13)
2 VS, PSP 2 Looks septic (3 SIRS criteria)
3 VS, PSP, chronicity 3 Mild respiratory distress
4 VS, PSP, chronicity 3 Fever (looks unwell), < 3 SIRS criteria
Penile Swelling, mild or Other 1st order modifiers
5
chronic pain 3 Acute peripheral severe pain (8-10) Mod
4 Chronic peripheral severe pain (8-10) CNS
5 Chronic peripheral pain ( < 8 ) dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 305 Scrotal pain and/or swelling

Scrot
al
pain ae
2
and/o VS, PSC Vital sign modifiers
r
3
swelli
ng
VS, PSC, chronicity 2 Hemodynamic compromise
Scrotal pain and/or 2 Looks septic (3 SIRS criteria)
swelling 3 Pulse rate/pressure abnormal (hemodynamically stable)

4 Acute central mild pain ( < 4 ) Hemo
dyn
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 306 Urinary retention

Urina
ae
2ry
retent
VS, PSC Vital sign modifiers
ion 2 Fever, immunocompromised
3 VS, PSC, chronicity 2 Looks septic (3 SIRS criteria)
4 Urinary retention 4 Fever (appears well), 1 SIRS criteria (fever)
If the patient is unstable Mod
Adult
choose another complaint CNS

Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 307 UTI complaints

UTI ae
2
comp VS, PSC Vital sign modifiers
laints
3 VS, PSC, PSP, chronicity 2 Hemodynamic compromise
4 VS, PSC, PSP, chronicity 2 Altered level of consciousness (GCS 10 - 13)
Chronic, mild UTI 2 Looks septic (3 SIRS criteria)
complaints/symptoms 3 Pulse rate/pressure abnormal (hemodynamically stable)
If the pain is suspected from 3 Acute peripheral severe pain (8-10) CNS
the bladder or above choose 3 Chronic central severe pain (8-10) Hemo
dyn
“central” pain, if suspected 4 Acute peripheral moderate pain ( 4- 7) Resp
from urethra then use 4 Chronic central moderate pain ( 4- 7) Temp
“peripheral” pain 5 Acute peripheral mild pain ( < 4 ) Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 308 Oliguria

ae
1
Oligu
ria
2 VS, PSC 1 Shock
4 Oliguria 2 Hemodynamic compromise
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 309 Polyuria
1
Polyu
ria
VS ae
1 Shock
4 Polyuria 2 Hemodynamic compromise
Adult

dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 310 Genital trauma

Genit
ae
1al
traum
a
2 VS, PSC, BD 1 Shock
3 Sexual assault, stable 1 Unconscious (GCS 3-9)
3 VS, PSC, BD 2 Hemodynamic compromise
4 VS, PS 2 Fever, immunocompromised
5 Genital trauma, no pain 3 Mild respiratory distress
Adult
dyn
3 Acute central moderate pain ( 4- 7) Resp
3 Chronic central severe pain (8-10) Temp

Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 351 Depression / Suicidal / Deliberate self harm

Depression /
attempted suicide or clear
Suicidal /
Suicidal Term Definition
2Deliberate
suicide plan
self harm Suicide Self injurious behavior with a non fatal
attempt outcome accompanied by evidence (explicit or
2 active suicidal intent implicit) that the person attempted to die.
Suicide intent Subjective expectation and desire for self-

uncertain flight or safety
2 destructive act that would end in death.
risk Suicidal Thought of serving as an agent of one’s own
ideation death, may vary in seriousness depending on
3 suicidal ideation, no plan specificity of plans and degree of suicidal
intent.
depressed, no suicidal
4 Uncertain Patients threatening violence towards
ideation themselves or others; patients exhibiting
Mod
Adult
flight or
uncontrolled anger, restlessness, paranoia, or
safety risk hallucinatory behavior; or patients unable or
CNS
Hemo
unwilling to cooperate with suicide risk dyn
Note: In Quebec this complaint is assessment and who pose a flight risk. Need
Resp
close observation based on site resources.
separated in 3 distinct complaints (If family member willing to observe & both Temp
parties agree ‘hospital-assigned’ close
Pain
observation may not be required.)
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 352 Anxiety / Situational crisis

Anxie
ty /
2
Situat severe anxiety / agitation Anxiety / Definition
ional Agitation
2
crisis
uncertain flight or safety risk
Severe Extreme unease, apprehension or worry with
signs of excessive circulating catecholamines;
3 moderate anxiety / agitation anxiety /
or dangerously agitated and uncooperative and
agitation
does not calm down when asked
4 mild anxiety / agitation
Moderate Clear unease, apprehension, or worry, but no
anxiety / obvious tachycardia or tremulousness; or signs
of agitation, and does not consistently obey
agitation
commands (e.g. will sit or calm down when
asked, but soon becomes restless and agitated
again Mod
Adult
Mild Mild unease, apprehension or worry, but can be CNS
anxiety / reassured; or restless but cooperative; obeys
Hemo
commands.
agitation dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 353 Hallucinations / Delusions

ae
2 VS
Hallucination
s / Delusions
acute psychosis, severe anxiety / agitation , 2 Moderate respiratory distress
2 uncertain flight or safety risk 2 Hemodynamic compromise
VS, moderate anxiety / agitation or with
3 paranoia
2
2
Fever, immunocompromised
Looks septic (3 SIRS criteria)
4 VS, mild agitation, stable 3 Pulse rate/pressure abnormal (hemodynamically stable)
5 mild anxiety / agitation, chronic hallucinations
Hallucination / Delusion Definition

Mod
Acute psychosis May present with extreme self neglect, disordered or racing thoughts or both, speech pattern Adult
impairments, impaired reality testing with ‘lack of insight’, may be responding to hallucinatory or CNS
delusional thoughts or both, which may be accompanied by hostility.
Hemo
dyn
Paranoia Delusions of a persecutory nature - being followed, poisoned, or harmed in some way. Ideas of
reference - the belief that people are talking about you. May be accompanied by extreme fear, Resp
agitation or hostility.
Temp
Chronic Known history of hallucinations with no recent change in nature, and/or frequency, or in
Pain
hallucinations patient’s level of distress related to them.
BD
Chronic, non-urgent Patient is well known to the ED and triage nurse with a recurrent complaint that has either been
condition fully dealt with, or patient is just looking for food, warmth or temporary shelter. MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 354 Insomnia
4
Inso
mnia
Acute insomnia
5 Chronic insomnia
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 355 Violent / Homicidal behaviour

Viole
nt /
Homi
imminent harm to self or
1
cidal
beha
viour
others or specific plans
2
risk
3 violent ideation, no plan
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 356 Social problem

Socia
l
abuse physical, mental,
3
probl
em high emotional stress
4 unable to cope
chronic, non urgent
5
condition
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 357 Bizarre behaviour

ae
1Bizarre
uncontrolled Vital sign modifiers
behaviour
2 VS 2 Hemodynamic compromise
uncertain flight or safety 2 Fever, immunocompromised
2
risk 2 Looks septic (3 SIRS criteria)
3 controlled 4 Fever (appears well), 1 SIRS criteria (fever)
Bizarre Behavior Definition

4 VS
Mod
Uncontrolled Bizarre, disoriented or irrational behavior, not Adult
4 harmless behaviour controlled by verbal communication and CNS
reasoning, and placing the patient or others
chronic, non urgent in physical danger
Hemo
5 dyn
condition Controlled Bizarre, irrational behavior that is viewed as Resp
threatening but controllable through verbal Temp

support and reasoning; patient is
accompanied by a friend or family member. Pain
BD
Harmless Bizarre or eccentric behavior (usually of long
behavior standing with no recent change from MOI
patient’s norm) that is of no threat to the
patient or others and requires no acute Def.
Last slide intervention.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 608 Concern for patient's welfare

Conc
ern
for
conflict or unstable Complaint to be used for
1
patie
nt's
welfa situation patients in whom the nurse
re
risk of flight or ongoing suspects abuse or neglect
2
abuse and there is no acute
3 physical or sexual assault medical problem.
history / signs of abuse or
4
maltreatment
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
607 Paediatric Disruptive behaviour
Code
NACRS
Pedia
tric
Disru
ptive
beha
viour
Peds specific
go to pediatric COT
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 401 Altered level of consciousness

Altere
d
level ae
1 VS
of
cons
2 VS, MOI
cious
ness 1 Shock
BS<3 mmol/L &/or
symptomatic 2 Hemodynamic compromise
2 High risk mechanism of injury CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 402 Confusion
2Conf VS ae
usion Vital sign modifiers
BS <3 mmol/L &/or 2 Moderate respiratory distress
2
acute , with headache or 2 Fever, immunocompromised
2
altered LOC 2 Looks septic (3 SIRS criteria)
acute without headache or 3 Fever (looks unwell), < 3 SIRS criteria
3 4 Fever (appears well), 1 SIRS criteria (fever)
altered LOC Mod
Adult
4 VS CNS
chronic, no change from Hemo

4 dyn
usual state Resp
Temp
LOC in this slide is Level of Consciousness Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 403 Vertigo
1
Vertig VS ae
o Vital sign modifiers
1 Shock
not positional +/- other 1 Unconscious (GCS 3-9)
2
neurological findings 2 Moderate respiratory distress
positional, no other neuro 2 Altered level of consciousness (GCS 10 - 13)
3
symptoms 2 Fever, immunocompromised
3 Pulse rate/pressure abnormal (hemodynamically stable) Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 404 Headache

ae
1
Head VS
ache Vital sign modifiers
2 sudden, severe, worst ever 1 Severe respiratory distress
1 Shock
visual acuity disturbance 1 Unconscious (GCS 3-9)
2
+/- eye pain 2 Moderate respiratory distress
2 VS, PSC 2 Altered level of consciousness (GCS 10 - 13)
3 VS, PSC, chronicity
Adult
Chronic or recurring 3 Fever (looks unwell), < 3 SIRS criteria
5 CNS
headache 4 Fever (appears well), 1 SIRS criteria (fever) Hemo
Other 1st order modifiers dyn
2 Acute central severe pain (8-10) Resp
3 Acute central moderate pain ( 4- 7) Temp

Pain
BD
5 Chronic central mild pain ( < 4 ) MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 405 Seizure
1
Seizu Actively seizing ae
re Vital sign modifiers
1 Shock
2 Post-ictal 1 Unconscious (GCS 3-9)
2 VS, PSC
Resolved, normal level of 2 Altered level of consciousness (GCS 10 - 13)
alertness
Mod
3 Pulse rate/pressure abnormal (hemodynamically stable) Adult
3 Fever (looks unwell), < 3 SIRS criteria CNS
Other 1st order modifiers Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 406 Gait disturbance / Ataxia

Gait
distur
1
banc VS ae
e/ Vital sign modifiers
Ataxi
2a Time of onset < 3 hrs 1 Severe respiratory distress
1 Shock
4 VS 2 Altered level of consciousness (GCS 10 - 13)
If considering a CVA go to: 3 Mild respiratory distress
Symptoms of a CVA 3 Pulse rate/pressure abnormal (hemodynamically stable)
Mod
Adult
4 Fever (appears well), 1 SIRS criteria (fever) Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 407 Head injury

ae
1
Head
injury
2 VS, PSC, MOI 1 Severe respiratory distress
1 Shock
New focal neurologic 1 Unconscious (GCS 3-9)
2
findings 2 Moderate respiratory distress
3 VS, PSC 2 Altered level of consciousness (GCS 10 - 13)
3 History of LOC 2 Looks septic (3 SIRS criteria)
Prolonged spinal 3 Mild respiratory distress
3 3 Pulse rate/pressure abnormal (hemodynamically stable) Mod
immobilization 3 Fever (looks unwell), < 3 SIRS criteria
Adult
CNS
4 No history of LOC 4 Fever (appears well), 1 SIRS criteria (fever)
Hemo
2 Bleeding disorder (life or limb threatening bleed) Temp
LOC on this slide = Loss of consciousness Pain
3 Bleeding disorder (moderate or minor bleeds) BD
4 Acute central mild pain ( < 4 ) MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 408 Tremor
2
Trem VS ae
or Vital sign modifiers
4 Chronic tremor 2 Altered level of consciousness (GCS 10 - 13)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
Extre
NACRS Code 409 Extremity weakness / Symptoms of CVA
mity
weak
ness ae
1 / VS
Symp Vital sign modifiers
2
toms
of
VS, PSC, BD 1 Severe respiratory distress
CVA 1 Shock
2 Time of onset < 3 hours 1 Unconscious (GCS 3-9)
3 VS, PSC, BD 2 Moderate respiratory distress
3 > 3 hours or resolved 2 Altered level of consciousness (GCS 10 - 13)
Note: as of 2008 in some institutions 2 Looks septic (3 SIRS criteria)
Time of onset is < 4.5 hrs Mod
May use pain scales if Other 1st order modifiers
CNS
Hemo
headache is present 2 Acute central severe pain (8-10) dyn
2 Bleeding disorder (life or limb threatening bleed) Resp

Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 410 Sensory loss / Paresthesias

Sens
ory
loss /
New onset sensory
3
Paras
thesi
as
loss/paresthesias
Chronic sensory
4
loss/paresthesias

Symptoms of a CVA
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 609 Floppy child

Flopp
y
child
Peds specific
go to pediatric COT
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 451 Menstrual problems

Mens
1
trual
probl
VS ae
ems
1 Shock
4 Menstrual problems 2 Moderate respiratory distress
This implies symptoms 2 Looks septic (3 SIRS criteria)
normally associated with 3 Mild respiratory distress
Mod
menses
dyn
Resp
4 Acute central mild pain ( < 4 ) Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 452 Foreign body, vagina

Forei
gn ae
1
body, VS
vagin Vital sign modifiers
2a VS, PSP 1 Severe respiratory distress
1 Shock
3 VS, PSP
4 VS, PSP 2 Moderate respiratory distress
5 Foreign body, vagina 2 Altered level of consciousness (GCS 10 - 13)
Mod

dyn
Resp
Temp
5 Acute peripheral mild pain ( < 4 ) Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 453 Vaginal discharge

Vagin
2al VS, PSP ae
disch
arge
5 Mild symptoms 2 Fever, immunocompromised
3 Acute peripheral severe pain (8-10) CNS

dyn
5 Acute peripheral mild pain ( < 4 ) Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 454 Sexual assault

Sexu
ae
1
al VS
assa Vital sign modifiers
ult
1 Shock
2 < 2 hours 1 Unconscious (GCS 3-9)
3 VS, PSC
3 >= 2 hours and < 12 hours 2 Altered level of consciousness (GCS 10 - 13)
4 >= 12 hours; no injury 2 Looks septic (3 SIRS criteria)
Mod
Suggested not to post this 3 Fever (looks unwell), < 3 SIRS criteria CNS
complaint on the tracking 4 Fever (appears well), 1 SIRS criteria (fever) Hemo
screen or board, but choose a
non offensive code word. 3 Acute central moderate pain ( 4- 7) Temp
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 455 Vaginal bleed

Vagin ae
1al VS
bleed Vital sign modifiers
2 VS, PSC, BD 1 Severe respiratory distress
1 Shock
Heavy vaginal bleeding +/- 1 Unconscious (GCS 3-9)
2
pregnancy 2 Moderate respiratory distress
3 VS, PSC, BD 2 Altered level of consciousness (GCS 10 - 13)
Vaginal bleeding –
normal VS 3 Mild respiratory distress
Vaginal bleeding - Adult
minor/spotting 4 Fever (appears well), 1 SIRS criteria (fever)
CNS
Hemo

Pain
4 Acute central mild pain ( < 4 ) BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 456 Labial swelling

Labia
2l
swelli
VS, PSP ae
ng
5 Labial swelling 2 Fever, immunocompromised
Mod

dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 460 Vaginal pain / itch

Vagin
3 PSP
al
pain /
ae
itch Other 1st order modifiers
4 PSP
5 Vaginal pain, itch 4 Acute peripheral moderate pain ( 4- 7)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 458 Pregnancy issues > 20 wks

Pregn
1ancy
VS ae
issue
s > 20 Vital sign modifiers
Presenting fetal parts, prolapsed
1wks 1 Severe respiratory distress
cord
1 Shock
1 Vaginal bleeding 3rd trimester 1 Unconscious (GCS 3-9)
2 VS, PSC, BD, MOI 2 Moderate respiratory distress
2 Active labor (contractions <2 min)
Pregnancy issues > 20 weeks no 2 Fever, immunocompromised
2
fetal movement / no fetal heart tones 2 Looks septic (3 SIRS criteria)
Pregnancy issues > 20 weeks 3 Mild respiratory distress
2 headache+/- edema+/- abdo pain+/- 3 Pulse rate/pressure abnormal (hemodynamically stable) Mod
Adult
hypertension 3 Fever (looks unwell), < 3 SIRS criteria CNS
2 Post delivery 4 Fever (appears well), 1 SIRS criteria (fever) Hemo
3 VS, PSC, BD 2 Acute central severe pain (8-10) Resp
3 Active labor (contractions > 2 min) 2 Bleeding disorder (life or limb threatening bleed) Temp
Pregnancy issues > 20 weeks 2 High risk mechanism of injury

Pain
3 3 Acute central moderate pain ( 4- 7)
possible leaking amniotic fluid
BD
4 Pregnancy issues > 20 weeks
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 457 Pregnancy issues < 20 wks

Pregn
ancy
1
issue VS ae
s < 20 Vital sign modifiers
2
wks VS, PSC, BD 1 Severe respiratory distress
1 Shock
Heavy vaginal bleeding +/-
2 1 Unconscious (GCS 3-9)
Vaginal bleeding - normal 2 Hemodynamic compromise
VS 2 Fever, immunocompromised
3 VS, PSC, BD 2 Looks septic (3 SIRS criteria)
Vaginal bleeding - minor / 3 Pulse rate/pressure abnormal (hemodynamically stable) Mod
4 Adult
spotting 3 Fever (looks unwell), < 3 SIRS criteria CNS
Pregnancy issues < 20 Hemo
4 Other 1st order modifiers dyn
weeks 2 Acute central severe pain (8-10) Resp

3 Acute central moderate pain ( 4- 7) Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 502 Chemical exposure, eye
2
ChemicalChemical exposure, eye
exposure, eye
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 503 Foreign body, eye

Forei
2
gn Penetrating foreign body ae
body,
eye Other 1st order modifiers
Acute or abrupt change in
2 3 Acute peripheral severe pain (8-10)
vision 4 Acute peripheral moderate pain ( 4- 7)
3 PSP 5 Acute peripheral mild pain ( < 4 )
4 PSP
5 Acute peripheral mild pain
Mod
Adult
CNS
Hemo
dyn
This includes corneal Resp
abrasions and corneal foreign Temp
body Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 504 Visual disturbance
acute or abrupt change in

Visual
2
disturbance
vision
chronic/gradual change in
4
vision
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 505 Eye pain
2
Eye
pain
PSC ae
2 2 Acute central severe pain (8-10)
vision
3 PSC, Chronicity 3 Chronic central severe pain (8-10)
4 PSC, Chronicity 4 Acute central mild pain ( < 4 )
5 Eye pain, chronic 4 Chronic central moderate pain ( 4- 7)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 506 Red Eye, discharge

Red
3
Eye, PSP, Chronicity ae
disch
arge Other 1st order modifiers
4 Red eye / discharge, acute
4 PSP, Chronicity 4 Acute peripheral moderate pain ( 4- 7)
Red eye / discharge, 4 Chronic peripheral severe pain (8-10)
5
chronic 5 Acute peripheral mild pain ( < 4 )
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 507 Photophobia

Photo
2
phobi PSC ae
a
3 PSC Other 1st order modifiers
4 Photophobia
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 508 Diplopia
3
Diplopia
Acute onset
4 Chronic diplopia

Symptoms of a CVA
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 509 Periorbital swelling

Perio
2
rbital VS, PSP ae
swelli Vital sign modifiers
ng
5 Periorbital swelling
Mod
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 510 Eye trauma

Eye
2
traum PSC, BD, MOI ae
a Other 1st order modifiers
Penetrating injury, 2 Acute central severe pain (8-10)
2 chemical or direct thermal 2 Bleeding disorder (life or limb threatening bleed)
burn 2 High risk mechanism of injury
Blunt mechanism of injury 3 Bleeding disorder (moderate or minor bleeds)
2
with visual loss 4 Acute central mild pain ( < 4 )
2
vision Mod
Adult
Nurse unable to visualize CNS
2
eye Hemo
dyn
3 PSC, BD, MOI Resp
Temp
Eye trauma, Acute central
4 Pain
mild pain (< 4)
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 511 Re-check eye

Re-
chec Acute or abrupt change in ae
2
k eye Other 1st order modifiers
vision
3 PSP 4 Acute peripheral moderate pain ( 4- 7)
5 Re-check eye
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 551 Back pain
1
Back VS ae
pain Vital sign modifiers
Neuro-deficit +/- bowel 1 Severe respiratory distress
2 1 Shock
bladder problems
2 VS, PSC 2 Moderate respiratory distress
5 Back pain 3 Mild respiratory distress
Mod
dyn
Resp
3 Chronic central severe pain (8-10) Pain

4 Acute central mild pain ( < 4 ) BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 552 Traumatic back / spine injury

Trau
matic
ae
1
back VS
/ Vital sign modifiers
spine
injury Neuro-deficit +/- bowel 1 Severe respiratory distress
2 1 Shock
bladder problems
2 VS, PSC, BD, MOI 2 Moderate respiratory distress
Traumatic back/spine
injury, mild central pain 3 Mild respiratory distress
Mod

Pain
BD
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 553 Amputation
1
Ampu VS ae
tation
Traumatic amputation of an 1 Severe respiratory distress
1
extremity. 1 Shock
2 VS, MOI, BD 2 Moderate respiratory distress
Traumatic amputation of a
digit. 2 Fever, immunocompromised
3 Amputation 2 Looks septic (3 SIRS criteria)
3 Mild respiratory distress Mod

dyn
Other 1st order modifiers Resp
Temp
3 Acute peripheral severe pain (8-10) Pain
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 556 Upper extremity injury

Uppe
r ae
1
extre VS Vital sign modifiers
mity
2
injury
VS, MOI, BD 1 Severe respiratory distress
1 Shock
Open fracture or neuro- 1 Unconscious (GCS 3-9)
vascular compromise
3 Obvious deformity 2 Altered level of consciousness (GCS 10 - 13)
3 VS, PSP, BD 2 Looks septic (3 SIRS criteria)
Tight cast with neuro- 3 Pulse rate/pressure abnormal (hemodynamically stable)
3 Mod
vascular compromise 3 Fever (looks unwell), < 3 SIRS criteria Adult
4 VS, PSP, Chronicity Other 1st order modifiers Hemo
2 Bleeding disorder (life or limb threatening bleed) dyn
Tight cast with no neuro- 2 High risk mechanism of injury Resp
4
vascular compromise 3 Acute peripheral severe pain (8-10) Temp
Upper extremity trauma, 4 Acute peripheral moderate pain ( 4- 7) Pain
5
chronic mild pain 4 Chronic peripheral severe pain (8-10) BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 557 Lower extremity injury

Lowe
r ae
1
mity
2
injury
VS, BD, MOI 1 Severe respiratory distress
1 Shock
Open fracture or neuro- 1 Unconscious (GCS 3-9)
vascular compromise
3 Obvious deformity 2 Altered level of consciousness (GCS 10 - 13)
3 VS, PSP, BD 2 Looks septic (3 SIRS criteria)
Tight cast with neuro- 3 Pulse rate/pressure abnormal (hemodynamically stable)
3 Mod
4 VS, PSP, Chronicity Other 1st order modifiers Hemo
Tight cast with no neuro- 2 High risk mechanism of injury Resp
4
vascular compromise 3 Acute peripheral severe pain (8-10) Temp
Lower extremity trauma, 4 Acute peripheral moderate pain ( 4- 7) Pain
5
chronic mild pain 4 Chronic peripheral severe pain (8-10) BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 554 Upper extremity pain

Uppe
r ae
1
mity
2
pain
VS, BD 1 Severe respiratory distress
1 Shock
Neuro-vascular 1 Unconscious (GCS 3-9)
compromise
Tight cast with neuro- 2 Looks septic (3 SIRS criteria)
vascular compromise
Mod
4 VS, PSP, Chronicity 3 Fever (looks unwell), < 3 SIRS criteria Adult
Tight cast with no neuro- Other 1st order modifiers
4 Hemo
dyn
vascular compromise 2 Bleeding disorder (life or limb threatening bleed)
3 Acute peripheral severe pain (8-10) Resp
Upper extremity chronic 3 Bleeding disorder (moderate or minor bleeds)

Temp
mild pain 4 Chronic peripheral severe pain (8-10) Pain
5 Acute peripheral mild pain ( < 4 ) BD

MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 555 Lower extremity pain

Lowe
r ae
1
mity
2
pain
1 Shock
3 VS, PSP 1 Unconscious (GCS 3-9)
Tight cast with neuro- 2 Hemodynamic compromise
3
vascular compromise 2 Altered level of consciousness (GCS 10 - 13)
4 VS, PSP, Chronicity 2 Looks septic (3 SIRS criteria)
Tight cast with no neuro- 3 Pulse rate/pressure abnormal (hemodynamically stable)
4 Mod
Lower extremity chronic Other 1st order modifiers
5 Hemo
dyn
mild pain 2 Bleeding disorder (life or limb threatening bleed)
3 Acute peripheral severe pain (8-10) Resp
Pain
5 Acute peripheral mild pain ( < 4 ) BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 558 Joint(s) swelling

Joint(
2s)
swelli
VS ae
ng
3 VS, PSP, BD 2 Moderate respiratory distress
4 VS, PSP, Chronicity 2 Altered level of consciousness (GCS 10 - 13)
5 Joint swelling 2 Looks septic (3 SIRS criteria)
Other 1st order modifiers Mod
3 Bleeding disorder (moderate or minor bleeds) CNS

dyn
Resp
5 Chronic peripheral pain ( < 8 ) Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 605 Paediatric gait disorder / painful walk

Pedia
tric
gait
disor
der /
painf
ul
walk
Peds specific
go to pediatric COT
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 858 Cast check

Cast
3
chec PSP ae
k
Tight cast with neuro-
3 3 Acute peripheral severe pain (8-10)
vascular compromise 4 Acute peripheral moderate pain ( 4- 7)
Tight cast with no neuro-
4
vascular compromise
5 Cast check or cast change
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 651 Shortness of breath

Short
ness
1
of VS ae
breat Vital sign modifiers
2
h
VS 1 Severe respiratory distress
1 Shock
Known asthmatic with FEV1 or 1 Unconscious (GCS 3-9)
2 PEFR <40% predicted (severe) 2 Moderate respiratory distress
Known asthmatic with FEV1 or 2 Fever, immunocompromised
3 PEFR 40-60% predicted 2 Looks septic (3 SIRS criteria)
(moderate) 3 Mild respiratory distress Mod
Adult
3 Pulse rate/pressure abnormal (hemodynamically stable) CNS
4 VS 3 Fever (looks unwell), < 3 SIRS criteria Hemo
dyn
Known asthmatic with FEV1 or Resp
4 PEFR >60% predicted (mild) Temp
Pain
SOB - shortness of breath, in

4 no distress
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 652 Respiratory arrest

Respi
1
ratory
arrest
Respiratory arrest
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 653 Cough / Congestion

Coug
h/ ae
2
Cong
estio
n 2 Moderate respiratory distress
Chronic cough / 3 Pulse rate/pressure abnormal (hemodynamically stable)
5 congestion with normal 3 Fever (looks unwell), < 3 SIRS criteria
vital signs 4 Fever (appears well), 1 SIRS criteria (fever)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 654 Hyperventilation

Hyper
1
ventil VS ae
ation Vital sign modifiers
1 Shock
3 VS
Hyperventilation resolved, 2 Moderate respiratory distress
4
appears well 2 Hemodynamic compromise
Mod
3 Mild respiratory distress Adult
3 Fever (looks unwell), < 3 SIRS criteria Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 655 Hemoptysis

Hemo
1
ptysi VS ae
s Vital sign modifiers
2 VS, BD 1 Severe respiratory distress
1 Shock
3 VS, BD 1 Unconscious (GCS 3-9)
4 Hemoptysis, appears well 2 Hemodynamic compromise
Mod
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 656 Respiratory foreign body

Respi
ratory
1
foreig VS ae
n Vital sign modifiers
2
body VS, PSC 1 Severe respiratory distress
1 Shock
2 Drooling or stridor
Hoarseness and 2 Moderate respiratory distress
2
dysphasia 2 Hemodynamic compromise
No distress but with 2 Looks septic (3 SIRS criteria)
difficulty swallowing Mod
Respiratory - foreign body, 3 Fever (looks unwell), < 3 SIRS criteria CNS
4 mild pain, appears in no 4 Fever (appears well), 1 SIRS criteria (fever) Hemo
dyn
distress Other 1st order modifiers
Resp
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 657 Allergic reaction

Allerg
1ic
reacti
VS ae
on Vital sign modifiers
1 Shock
2 Previous severe reaction 1 Unconscious (GCS 3-9)
Hay fever causing nasal
congestion 3 Mild respiratory distress
Mod

dyn
Resp
4 Acute peripheral moderate pain ( 4- 7) Temp
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 610 Stridor

Strid
or
Peds specific
go to pediatric COT
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 604 Wheezing – no other complaints

Whee
zing
– no
other
comp
laints
Peds specific
go to pediatric COT
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 606 Apneic spells in infants

Apnei
c
spell
s in
infant
s
Peds specific
go to pediatric COT
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 701 Bite
1
Bite VS ae
1 Shock
5 Minor bite 2 Looks septic (3 SIRS criteria)
Adult
Hemo
4 Fever (appears well), 1 SIRS criteria (fever) dyn
Temp
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 702 Sting
1
Sting VS ae
1 Shock
2 Previous severe reaction
5 Sting
Adult
Hemo
4 Fever (appears well), 1 SIRS criteria (fever) dyn
Temp
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 703 Abrasion
3
Abras PSP ae
ion
4 PSP
5 Minor abrasion 4 Acute peripheral moderate pain ( 4- 7)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 704 Laceration / Puncture

Lacer
ation ae
1 / VS Vital sign modifiers
Punct
2
ure
1 Shock
Complex wound with 1 Unconscious (GCS 3-9)
2
neurovascular compromise 2 Moderate respiratory distress
3 VS, PSP, BD 2 Altered level of consciousness (GCS 10 - 13)
3 Active bleeding 2 Looks septic (3 SIRS criteria)
4 VS, PSP 3 Pulse rate/pressure abnormal (hemodynamically stable) Mod
Adult
Bleeding
4 4 Fever (appears well), 1 SIRS criteria (fever) CNS
resolved/controlled Other 1st order modifiers Hemo
dyn
4 Sutures required Resp
5 No sutures required 3 Bleeding disorder (moderate or minor bleeds) Temp
4 Acute peripheral moderate pain ( 4- 7) Pain

BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 705 Burn
1
Burn VS ae
1 Shock
2 Burn >25% Body surface area 1 Unconscious (GCS 3-9)
(BSA) 2 Moderate respiratory distress
Partial/full thickness to
hands, feet, face, perineum 2 Fever, immunocompromised
Mod
3 Burn 5 -25% BSA 3 Pulse rate/pressure abnormal (hemodynamically stable) Adult
4 VS, PSP 4 Fever (appears well), 1 SIRS criteria (fever) Hemo
<5% BSA Full; or 3 Acute peripheral severe pain (8-10)
4 Resp
<10% BSA partial thickness 4 Acute peripheral moderate pain ( 4- 7) Temp

5 Burn mild pain Pain
BD
BSA estimation
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 706 Blood and body fluid exposure

Blood
and
body
fluid High risk exposure:
expo
sure defined as needle stick,
hollow bore needle,
2 known or suspected HIV or
hepatitis +ve source
High risk unless known low risk
source
Low risk exposure: Mod

Adult
3 defined as non hollow bore CNS
needle or fluid splash from low Hemo

dyn
risk source Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 707 Pruritus
3
Prurit PSP ae
is
4 PSP 3 Acute peripheral severe pain (8-10)
5 Pruritis 4 Acute peripheral moderate pain ( 4- 7)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 708 Rash
2 VS ae
Rash
Facial cellulitis, 2 Moderate respiratory distress
particularly periorbital area
Purpuric or petechial rash; 2 Fever, immunocompromised
2
appears ill 2 Looks septic (3 SIRS criteria)
3 VS, PSP 3 Pulse rate/pressure abnormal (hemodynamically stable)
Mod
4 Localized cellulitis Other 1st order modifiers Adult
5 Localized rash 4 Acute peripheral moderate pain ( 4- 7) Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 709 Localized swelling / redness

Local
ized
1
swelli VS ae
ng / Vital sign modifiers
redne
2ss VS 1 Severe respiratory distress
1 Shock
Facial cellulitis, 1 Unconscious (GCS 3-9)
2
particularly periorbital area 2 Moderate respiratory distress
Purpuric or petechial rash;
appears ill 2 Fever, immunocompromised
Mod
4 VS, PSP 3 Pulse rate/pressure abnormal (hemodynamically stable) Adult
4 Localized cellulitis 4 Fever (appears well), 1 SIRS criteria (fever) Hemo
dyn
5 Localized rash 3 Acute peripheral severe pain (8-10)
Resp
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 710 Wound check

Woun
ae
3
d
chec
k
5 Wound check 3 Fever (looks unwell), < 3 SIRS criteria
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 711 Other skin conditions

Other
ae
3
skin
condi
tions
5 Other skin conditions 3 Fever (looks unwell), < 3 SIRS criteria
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 712 Lumps, bumps, calluses

Lump
s,
2
bump
s,
VS ae
callu Vital sign modifiers
3
ses VS, PSP 2 Moderate respiratory distress
5 Lumps, bumps calluses 2 Fever, immunocompromised
Mod

dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 713 Redness / tenderness, breast

Redn
ess /
tende
2
rness VS ae
, Vital sign modifiers
3
breas
t
VS, PSP 2 Moderate respiratory distress
Redness / tenderness, 2 Fever, immunocompromised
breast
Mod

dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 714 Rule out infestation

Rule
3
out PSP ae
infest
ation Other 1st order modifiers
4 PSP
5 Rule out infestation 4 Acute peripheral moderate pain ( 4- 7)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 715 Cyanosis

ae
1
Cyan
osis
2 VS 1 Shock
3 Cyanosis 2 Moderate respiratory distress
2
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 716 Spontaneous bruising

Spont
aneo ae
1
us VS
bruisi Vital sign modifiers
2
ng
1 Shock
3 Spontaneous bruising 1 Unconscious (GCS 3-9)
Adult
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 717 Foreign body, skin

Forei
3
gn
body,
VS, PSP ae
skin
5 Foreign body, skin 3 Fever (looks unwell), < 3 SIRS criteria
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 857 Removal staples / sutures

Remo
val
3
stapl VS, PSP ae
es / Vital sign modifiers
sutur
4es VS, PSP 3 Mild respiratory distress
Removal of staples /
sutures 4 Fever (appears well), 1 SIRS criteria (fever)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 751 Substance misuse / Intoxication

Subst
ance
misu
1 VS ae
se /
Intoxi Vital sign modifiers
2
catio
n
1 Shock
High risk substance / 1 Unconscious (GCS 3-9)
2
unknown substance 2 Moderate respiratory distress
Uncertain flight or safety
risk 2 Fever, immunocompromised
3 VS
4 Known low risk substance 3 Pulse rate/pressure abnormal (hemodynamically stable) Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 752 Overdose ingestion

Over
ae
1
dose
inges
tion
1 Shock
2
Uncertain flight or safety 2 Altered level of consciousness (GCS 10 - 13)
2
risk 2 Fever, immunocompromised
Attempted suicide, clear 3 Mild respiratory distress
2
plan 3 Pulse rate/pressure abnormal (hemodynamically stable) Mod
Adult
3 VS 4 Fever (appears well), 1 SIRS criteria (fever) CNS
Hemo
dyn
3 Suicidal ideation, no plan Resp
4 Overdose ingestion Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 753 Substance withdrawal

Subst
ae
1
ance
withd
rawal
1 Actively seizing 1 Severe respiratory distress
1 Shock
Recent seizures, post ictal,
agitated 2 Altered level of consciousness (GCS 10 - 13)
Uncertain flight or safety 2 Looks septic (3 SIRS criteria)
2
risk 3 Mild respiratory distress
2 Severe anxiety/agitation 3 Fever (looks unwell), < 3 SIRS criteria
Adult
CNS
3 VS Hemo
dyn
3 Moderate anxiety/agitation Resp
4 Mild anxiety/agitation Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 801 Major trauma – penetrating

Major
traum
1a– VS ae
penet Vital sign modifiers
2
rating
VS, PSC, BD, MOI 1 Severe respiratory distress
1 Shock
Neurovascular 1 Unconscious (GCS 3-9)
2
compromise of extremity 2 Moderate respiratory distress
Penetrating head, chest, 2 Altered level of consciousness (GCS 10 - 13)
2
abdomen 2 Fever, immunocompromised
3 Major trauma - penetrating 3 Mild respiratory distress
Adult

dyn
Resp
3 Bleeding disorder (moderate or minor bleeds) Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 802 Major trauma – blunt

Major
1
traum
a–
VS ae
blunt
2 VS, PSC, BD, MOI 1 Severe respiratory distress
1 Shock
Neurovascular compromise
of extremity 2 Moderate respiratory distress
Prolonged spinal
immobilization 2 Fever, immunocompromised
3 VS, PSC, BD 2 Looks septic (3 SIRS criteria)
4 Major trauma-blunt 3 Pulse rate/pressure abnormal (hemodynamically stable) Mod
Adult
CNS
Hemo
Temp
3 Acute central moderate pain ( 4- 7) Pain

MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 803 Isolated chest trauma – penetrating

Isolat
ed
chest
1 VS ae
traum
a– Vital sign modifiers
2
penet
rating
1 Shock
Isolated chest trauma -
penetrating 2 Moderate respiratory distress
Mod
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 804 Isolated chest trauma – blunt

Isolat
ed
ae
1
chest
traum
a–
2
blunt VS, PSC, BD, MOI
1 Shock
VS, PSC, PSP for chest wall 1 Unconscious (GCS 3-9)
pain, BD 2 Hemodynamic compromise
blunt (appears well) 2 Looks septic (3 SIRS criteria)
Adult
CNS
dyn
Resp
3 Acute peripheral severe pain (8-10) Pain
BD
4 Acute peripheral moderate pain ( 4- 7) MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 805 Isolated abdominal trauma – penetrating

Isolat
ed
abdo
1
minal VS ae
traum
a– Vital sign modifiers
penet Isolated abdominal trauma 1 Severe respiratory distress
2
rating
- penetrating 1 Shock
Mod
2 Acute central severe pain (8-10) CNS

dyn
2 High risk mechanism of injury Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 806 Isolated abdominal trauma – blunt

Isolat
ed
abdo
1
minal VS ae
traum Vital sign modifiers
2a–
blunt VS, PSC, BD, MOI 1 Severe respiratory distress
1 Shock
3 VS, PSC, BD 1 Unconscious (GCS 3-9)
Isolated abdominal blunt 2 Moderate respiratory distress
trauma
Mod
dyn
Resp
2 High risk mechanism of injury Pain
BD
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 851 Exposure to communicable disease

Expo
sure
to
com
Exposure to
5
muni
cable
disea
communicable disease
se
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 852 Fever
1
Fever VS ae
2 Petechial rash 1 Shock
4 Fever 2 Hemodynamic compromise
Adult
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 853 Hyperglycemia

Hyper
1
glyce VS ae
mia
2 >18 mmol/L symptomatic 1 Severe respiratory distress
1 Shock
>18 mmol/L not 1 Unconscious (GCS 3-9)
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 854 Hypoglycemia

Hypo
1
glyce VS ae
mia
2 <3 mmol/L symptomatic 1 Severe respiratory distress
1 Shock
<3 mmol/L not 1 Unconscious (GCS 3-9)
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 855 Direct referral for consultation

Direct
referr
ae
1
al for
cons
ultati 1 Severe respiratory distress
2on VS, PSC, PSP 1 Shock
3 VS, PSC, PSP, Chronicity 2 Moderate respiratory distress
4 VS, PSC, PSP, Chronicity 2 Altered level of consciousness (GCS 10 - 13)
Direct referral for
consultation 3 Mild respiratory distress
Adult
3 Acute central moderate pain ( 4- 7) Hemo

dyn
4 Chronic central moderate pain ( 4- 7) Pain
4 Chronic peripheral severe pain (8-10) BD
5 Acute peripheral mild pain ( < 4 ) MOI
5 Chronic peripheral pain ( < 8 ) Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 856 Dressing change

Dress
3
ing
chan
VS, PSP ae
ge
5 Dressing change 3 Fever (looks unwell), < 3 SIRS criteria
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 859 Imaging tests

Imagi
5
ng Imaging test
tests
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 860 Medical device problem

Medic
al
1
devic VS ae
e Vital sign modifiers
probl
2
em VS, PSC, PSP 1 Severe respiratory distress
1 Shock
3 VS, PSC, PSP 1 Unconscious (GCS 3-9)
Medical device problem; 2 Hemodynamic compromise
4 'asymptomatic' or 'no 2 Altered level of consciousness (GCS 10 - 13)
distress' 2 Fever, immunocompromised
Adult
CNS
Hemo

Pain
4 Acute peripheral moderate pain ( 4- 7) BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 861 Prescription / Medication request

Presc
riptio
n/
Medic Prescription / medication
5
ation
reque request
st
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 862 Ring removal

Ring ae
remo Neuro-vascular
2
val Vital sign modifiers
compromise 3 Fever (looks unwell), < 3 SIRS criteria
3 VS, PSP
4 VS, PSP 3 Acute peripheral severe pain (8-10)
5 Ring removal 5 Acute peripheral mild pain ( < 4 )
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 863 Abnormal lab values

Abno
rmal
2 VS, BD ae
lab
value Vital sign modifiers
3s
1 Shock
3 Normal VS, critical value 1 Unconscious (GCS 3-9)
4 VS
Normal VS, non critical 2 Altered level of consciousness (GCS 10 - 13)
value
Mod
dyn
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 865 Post-operative complications

Post-
opera
2
tive VS, PSC, BD ae
comp Vital sign modifiers
licati
3
ons VS, PSC, PSP, BD 2 Moderate respiratory distress
4 VS, PSC, PSP 2 Altered level of consciousness (GCS 10 - 13)
Normal VS, no pain, 2 Fever, immunocompromised
routine check 3 Mild respiratory distress
Mod

dyn
Resp
Temp
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 864 Pallor / Anemia

Pallor
1 / VS ae
Anem Vital sign modifiers
ia
2 VS, BD 1 Severe respiratory distress
1 Shock
4 Pallor / Anemia
Mod
dyn
Resp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 603 Inconsolable crying in infants

Incon
solab
le
cryin
g in
infant
s
Peds specific
go to pediatric COT
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 611 Congenital problem in children

Cong
enital
probl
em in
childr
en
Peds specific
go to pediatric COT
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
NACRS Code 866 Minor complaints NOS

Minor
2
comp
laints
VS, PSC, PSP ae
NOS
3 VS, PSC, PSP, Chronicity 2 Moderate respiratory distress
4 VS, PSC, PSP, Chronicity 2 Altered level of consciousness (GCS 10 - 13)
Minor complaints, 2 Looks septic (3 SIRS criteria)
5
unspecified 3 Mild respiratory distress
Mod
3 Acute peripheral severe pain (8-10) Hemo
dyn

Pain
5 Acute peripheral mild pain ( < 4 ) MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
Qc Code 480 Diarrhea & Fever (Qc)

Diarr
1
hea &
Fever
VS, severe dehydration ae
(Qc) Vital sign modifiers
VS, moderate 1 Severe respiratory distress
2
dehydration 1 Shock
Uncontrolled bloody
diarrhea 2 Hemodynamic compromise
Mod
3 Mild respiratory distress Adult
Note: In Quebec the MSSS 4 Fever (appears well), 1 SIRS criteria (fever)
dyn
has designated Resp
“Diarrhea and fever” as a Temp
separate complaint from Pain
Diarrhea or Fever BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
Qc Code 600 Depression (Qc)

Depre
ssion
2
(Qc)
risk Suicide Self injurious behavior with a non fatal
attempt outcome accompanied by evidence (explicit
depressed, no suicidal or implicit) that the person attempted to die.
4
ideation Suicide intent Subjective expectation and desire for self-
destructive act that would end in death.
Note: In Quebec Depression / Suicidal Thought of serving as an agent of one’s

ideation own death, may vary in seriousness
Suicidal / Deliberate self harm depending on specificity of plans and
degree of suicidal intent.
is separated in 3 distinct
complaints Uncertain Patients threatening violence towards Mod
flight or themselves or others; patients exhibiting Adult
uncontrolled anger, restlessness, paranoia,
safety risk or hallucinatory behavior; or patients unable
CNS
Hemo
or unwilling to cooperate with suicide risk dyn
Resp
Need close observation based on site
resources. Temp
(If family member willing to observe & both
Pain
observation may not be required.) BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
Qc Code 680 Suicidal ideations (Qc)

Suici
dal
2
ideati clear suicide plan Suicidal Term Definition
ons
2
(Qc)
active suicidal intent Suicide Self injurious behavior with a non fatal
or implicit) that the person attempted to die.
2 Suicide intent Subjective expectation and desire for self-
risk destructive act that would end in death.
3 suicidal ideation, no plan Suicidal Thought of serving as an agent of one’s
depending on specificity of plans and
Note: In Quebec Depression / degree of suicidal intent.
Suicidal / Deliberate self harm Uncertain Patients threatening violence towards Mod
themselves or others; patients exhibiting
is separated in 3 distinct flight or
Adult
safety risk CNS

complaints or hallucinatory behavior; or patients unable
Hemo
Resp
resources. Temp
Pain
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
Qc Code 681 Suicide attempt (Qc)

Suici
de
2 attempted suicide
attem
pt
Suicide Self injurious behavior with a non fatal
(Qc)
2 attempt outcome accompanied by evidence (explicit
risk or implicit) that the person attempted to die.

Note: In Quebec Depression /
Suicidal / Deliberate self harm ideation own death, may vary in seriousness
is separated in 3 distinct depending on specificity of plans and
complaints
Uncertain Patients threatening violence towards Mod
flight or themselves or others; patients exhibiting Adult
CNS
Hemo
Resp
resources. Temp
Pain
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ADULT COT
system
Coding
Qc Code 1180 Cough and Fever (Qc)

Coug
ae
2
h and VS
Fever Vital sign modifiers
(Qc)
Note: In Quebec “Cough and
fever” is a separate complaint 3 Fever (looks unwell), < 3 SIRS criteria
from Cough or Fever 4 Fever (appears well), 1 SIRS criteria (fever)
Mod
Adult
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Def.
Last slide
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
Colour schemes
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Pediatrics: Critical Look
PedIATRIC COT
1st step 2nd step
W
ce
an l
pe era
Br
or
ko g Master
ea
Ap Gen
ar
PRESENTING
th
f COMPLAINT
list
in
CRITICAL
Ped
LOOK mod
Critic
look
CNS
Hemo
Circulation
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Peds: Modifiers
PedIATRIC COT
Critical look: Vital signs Other 1st order modifiers
Level of consciousness Bleeding Modifiers
1 Unconscious (GCS 3-9) 2 Bleeding disorder (life or limb threatening bleed)
2 Altered level of consciousness (GCS 10 - 13) 3 Bleeding disorder (moderate or minor bleeds)
Hemodynamic Status Mechanism of Injury

1 Shock 2 High risk mechanism of injury
3 Vital signs outside the limits of normal Acute Pain
2 Acute severe pain (8-10)
Respiratory Modifiers 3 Acute moderate pain ( 4- 7)
1 Severe respiratory distress 4 Acute mild pain ( < 4 )
2 Moderate respiratory distress Chronic Pain Ped
mod
3 Mild respiratory distress 3 Chronic severe pain (8-10) Critic
look
4 Chronic moderate pain ( 4- 7)
Temperature Modifiers* 5 Chronic mild pain ( < 4 ) CNS
2 Fever, immunocompromised Hemo
2 <3 mos, T < 36C OR >38C dyn
2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic) Resp

3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
Temp
3 >36 mos, T >38.5C, & appearing unwell (toxic)
4 >36 mos, T >38.5 C & appearing well (non-toxic) Pain
* can be applied on a documented Hx of fever even if patient BD
afebrile at triage
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Peds: Respiratory modifiers
PedIATRIC COT
CT O2 PEFR
AS Peds: Level of Respiratory Distress Sat
Severe: excessive work of breathing, cyanosis;

lethargy, confusion,inability to recognize caregiver,
decreased response to pain; single word or no
speech; tachycardia or bradycardia; tachypnea or
1 bradypnea, apnea, irregular respirations; exaggerated
retractions, nasal flaring; grunting; absent or
<90
%
-
decreased breath sounds; upper airway obstruction

(dysphagia, drooling, muffled voice, laboured
respirations and stridor); unprotected airway (weak to
absent cough or gag reflex); poor muscle tone
Moderate: increased work of breathing, Ped

mod
restlessness, anxiety or combativeness; tachypnea;
Critic
2 hyperpnea; mild increased use of accessory muscles,
retractions, flaring, speaking phrases or clipped
<92
%
<40% look
CNS
sentences, stridor but airway protected, prolonged
expiratory phase. Hemo
dyn
Resp
Mild: Dyspnea; tachypnea; shortness of breath on
exertion; no obvious increased work if breathing; able Temp
3 to speak in sentences; stridor without obvious airway
obstruction; mild shortness of breath on exertion;
92 -
94%
40 -
60%
Pain
frequent cough BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Peds: Hemodynamic modifiers
PedIATRIC COT
CTAS Circulatory Status
Shock: evidence of severe end-organ

hypoperfusion, marked pallor, cool skin,
diaphoresis, weak or thready pulse,
hypotension, postural syncope, significant
1 tachycardia or bradycardia, ineffective
ventilation or oxygenation, decreased level
of consciousness; could also appear as
flushed, febrile, toxic, as in septic shock
Hemodynamic compromise: delayed

capillary refill, tachycardia, decreased urine
Ped
production and skin changes suggest poor mod
tissue perfusion; vomiting and diarrhea Critic
look
secondary to gastrointestinal infection are a
2 common etiology; the signs of dehydration
CNS
Hemo
are not always reliable, particularly in dyn
younger patients; hemorrhage in moderate Resp
trauma may be masked by a child’s ability to
maintain his or her blood pressure Temp
Pain
Volume depletion with abnormal vital
3 signs
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Peds: Level of consciousness
PedIATRIC COT
CTAS Level of Consciousness GCS
Level
Unconscious: unresponsive; responds to pain or loud noise

only and without purpose; flexion or extension position;
1 continuous seizing; progressive deterioration in level of
3-9
consciousness; unable to protect airway
Altered level of consciousness: a change from one’s “normal”

level of consciousness; lethargic; obtunded; localizes to painful
Ped
stimulus; confused; disoriented; restless; irritable; agitated or mod
2 combative; inconsolable, poor feeding in an infant; able to protect
10 - 13 Critic
look
his/her airway; alert with minor behavioural or vital sign CNS
alterations from normal Hemo
dyn
Resp
Temp
GCS Pain
definitions BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
Peds: Mechanism of injury modifiers
MOI CTAS Level 2
General MVC: Ejection from vehicle, rollover, extrication time>20 minutes, significant intrusion
Trauma into passenger’s space, death in the same passenger compartment, impact >40 km/h
(unrestrained) or impact>60 km/h (restrained)
MCC: Where impact with a car>30 km/hr, especially if rider is separated from
motorcycle
Pedestrian or bicyclist Run over or struck by vehicle at >10 km/h
Fall: of >3 ft (>1 m) or 5 stairs
Penetrating injury: To head, neck, torso or extremities proximal to elbow and knee
Head MVC: ejection from vehicle, unrestrained passenger striking head on windshield Ped
mod
Trauma Pedestrian: struck by vehicle Critic
Fall: from >3 ft (>1 m) or 5 stairs look
Assault: With blunt object other than fist or feet CNS

Hemo
dyn
Neck MVC: ejection from vehicle, rollover, high speed (esp. if driver unrestrained) Resp
Trauma MCC: impact with a car > 30 km/hr, especially if rider is separated from motorcycle
Fall: from >3 ft (>1 m) or 5 stairs Temp
Axial load to the head Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Peds: Fever
PedIATRIC COT
CTAS (age <17 years)
Level
Immunocompromised: neutropenia (or

2 suspected), chemotherapy or on
immunosupressive drugs including steroids.
2 <3 months, T < 36°C OR >38°C
3-36 months, T <32°C OR >38.5°C , & appearing

2 unwell (toxic) Ped
mod
Critic
3-36 months, T 32-35°C OR >38.5°C & appearing look
3 well (non-toxic) CNS
Hemo
dyn
3 >36 months, T >38.5°C , & appearing unwell (toxic) Resp
Temp
>36 months, T >38.5°C & appearing well (non-
4 toxic)
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Peds: Pain
PedIATRIC COT
SEVERE 8 -10 2
ACUTE MODERATE 4-7 3
MILD 3 0-3 4
PAIN
Ped
SEVERE 8 -10 3 mod
Critic
look
CHRONIC MODERATE 4-7 4 CNS

Hemo
dyn
MILD <4 5 Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
Peds: Bleeding disorder (congen. / acq.)
Life or Limb Threatening Moderate or minor
CTAS level 2 CTAS level 3
Head (intracranial) & neck Nose (epistaxis)
Chest,abdomen,pelvis,spine Mouth (including gums)
Massive vaginal hemorrhage Joints (hemarthroses)
Iliopsoas muscle & hip Menorrhagia
Ped
mod
Extremity muscle compartments Abrasions Critic
look
Fractures & dislocations Superficial lacerations CNS

Hemo
dyn
Deep lacerations Resp
Any uncontrolled bleeding Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
Def: suicidality, anxiety, agitation
Suicidal Term Definition Anxiety / Definition
Agitation
Suicide Self injurious behavior with a non fatal Severe Extreme unease,
attempt outcome accompanied by evidence (explicit anxiety / apprehension or worry with
or implicit) that the person attempted to die. signs of tachycardia,
agitation
agitiation; or dangerously
Suicide intent Subjective expectation and desire for self- agitated and uncooperative
destructive act that would end in death. and does not calm down when
asked
Moderate Clear unease, apprehension,
anxiety / or worry, but no obvious
tachycardia or tremulousness;
degree of suicidal intent. agitation or signs of agitation, and does Ped
mod
not consistently obey
Uncertain flight Patients threatening violence towards
commands (e.g. will sit or Critic
themselves or others; patients exhibiting look
or safety risk calm down when asked, but
uncontrolled anger, restlessness, paranoia, CNS
or hallucinatory behavior; or patients unable soon becomes restless and
agitated again Hemo
assessment and who pose a flight risk. Resp
resources. Mild anxiety Mild unease, apprehension or
Temp
/ agitation worry, but can be reassured;
(If family member willing to observe & both or restless but cooperative; Pain
parties agree ‘hospital-assigned’ close obeys commands.
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
Def: Psychosis, paranoia, hallucinations, chronic, Bizarre behaviour
Hallucination / Definition Bizarre Definition

Delusion Behavior
Acute May present with extreme self neglect, Uncontrolled Bizarre, disoriented or
psychosis disordered or racing thoughts or both, irrational behavior, not
speech pattern impairments, impaired reality controlled by verbal
testing with ‘lack of insight’, may be communication and
responding to hallucinatory or delusional reasoning, and placing the
thoughts or both, which may be patient or others in physical
accompanied by hostility. danger
Paranoia Delusions of a persecutory nature - being Controlled Bizarre, irrational behavior

followed, poisoned, or harmed in some way. that is viewed as threatening
Ideas of reference - the belief that people but controllable through Ped
are talking about you. May be accompanied verbal support and reasoning; mod
by extreme fear, agitation or hostility. patient is accompanied by a Critic
look
friend or family member.
Chronic Known history of hallucinations with no CNS
hallucination recent change in nature, and/or frequency, Hemo

or in patient’s level of distress related to Harmless Bizarre or eccentric behavior dyn
s (usually of long standing with
them. behavior Resp
no recent change from
Chronic, Patient is well known to the ED and triage patient’s norm) that is of no Temp
non-urgent nurse with a recurrent complaint that has threat to the patient or others
either been fully dealt with, or patient is just and requires no acute Pain
condition
looking for food, warmth or temporary intervention. BD
shelter.
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Substance misuse
PedIATRIC COT
Substance misuse / Intoxication
Overdose ingestion
Ped
mod
Critic
look
Substance withdrawal CNS

Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Mental health and psychosocial issues
PedIATRIC COT
Anxiety / Situational crisis Social problem
Hallucinations / Delusions Bizarre behaviour
Insomnia Concern for patient's welfare
Violent / Homicidal behaviour Pediatric Disruptive behaviour

Ped
mod
Depression / Suicidal / Critic

look
Deliberate self harm CNS

Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Neurologic
PedIATRIC COT
Altered level of Extremity weakness /
consciousness Symptoms of CVA
Confusion Head injury
Vertigo Tremor
Ped
mod
Headache Sensory loss / Parasthesias Critic
look
CNS
Seizure Floppy child Hemo
dyn
Resp
Gait disturbance / Ataxia Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Ophthalmology
PedIATRIC COT
Chemical exposure, eye Photophobia
Foreign body, eye Diplopia
Visual disturbance Periorbital swelling
Eye pain Eye trauma Ped

mod
Critic
Red Eye, discharge Re-check eye look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Ent-nose
PedIATRIC COT
Epistaxis
Nasal congestion / Hay fever
Foreign body, nose
URTI complaints Ped

mod
Critic
look
Nasal trauma CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ENT- Ears
PedIATRIC COT
Earache
Foreign body ear
Loss of hearing
Tinnitus Ped
mod
Critic
Discharge, ear look
CNS
Hemo
dyn
Ear injury Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
ENT – Mouth, Throat, Neck
PedIATRIC COT
Dental / Gum problems
Facial trauma
Sore throat
Neck swelling / pain Ped

mod
Critic
look
Neck trauma CNS

Hemo
dyn
Resp
Difficulty swallowing / Dysphagia
Temp
Pain
Facial pain (non-traumatic / non-dental) BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Respiratory
PedIATRIC COT
Shortness of breath Respiratory foreign body
Respiratory arrest Allergic reaction
Hyperventilation Stridor
Hemoptysis Apneic spells in infants Ped

mod
Critic
Cough / Congestion Wheezing – no other look
CNS
complaints Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Cardiovascular
PedIATRIC COT
Cardiac arrest (non traumatic) General weakness
Cardiac arrest (traumatic) Syncope / Pre-syncope
Chest pain (cardiac features) Edema, generalized
Chest pain (non cardiac features) Bilateral leg swelling / Edema Ped
mod
Critic
look
Palpitations / Irregular heart beat Cool pulseless limb CNS
Hemo
dyn
Hypertension Unilateral reddened hot limb Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Gastrointestinal
PedIATRIC COT
Abdominal pain Vomiting blood
Anorexia Blood in stool / Melena
Constipation Jaundice
Foreign body in rectum Hiccoughs
Groin pain / mass Abdominal mass / distention Ped

mod
Critic
look
Vomiting and/or nausea Anal / Rectal trauma CNS
Hemo
Rectal / Perineal pain Oral / Esophageal Foreign dyn
Resp
Diarrhea Feeding difficulties in newborn Temp
Pain
Neonatal jaundice BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Obstetrics-gynecology
PedIATRIC COT
Menstrual problems Vaginal bleed
Foreign body, vagina Labial swelling
Vaginal discharge Pregnancy issues < 20 wks
Vaginal pain / itch Pregnancy issues > 20 wks Ped

mod
Critic
Sexual assault look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Genito-urinary
PedIATRIC COT
Flank pain Urinary retention
Hematuria UTI complaints
Genital discharge / lesion Oliguria
Penile swelling Polyuria Ped

mod
Critic
look
Scrotal pain and/or swelling Genital trauma CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Orthopedic
PedIATRIC COT
Back pain Upper extremity injury
Traumatic back / spine injury Lower extremity injury
Amputation Joint(s) swelling
Upper extremity pain Cast check Ped

mod
Critic
Lower extremity pain Pediatric gait disorder / look
CNS
painful walk Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Trauma
PedIATRIC COT
Major trauma – penetrating
Major trauma – blunt
Isolated chest trauma – penetrating

Ped
Isolated chest trauma – blunt mod
Critic
look
CNS
Hemo
dyn
Isolated abdominal trauma – penetrating Resp
Temp
Isolated abdominal trauma – blunt Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Environmental
PedIATRIC COT
Frostbite / Cold injury
Noxious inhalation
Electrical injury
Chemical exposure Ped

mod
Critic
look
Hypothermia CNS
Hemo
dyn
Near Drowning Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Skin
PedIATRIC COT
Bite Rash
Sting Redness / tenderness, breast
Abrasion Localized swelling / redness
Laceration / Puncture Lumps, bumps, calluses
Burn Rule out infestation Ped
mod
Critic
look
Blood and body fluid exposure Cyanosis CNS
Hemo
Foreign body, skin Spontaneous bruising dyn
Resp
Wound check Pruritis Temp
Pain
Removal staples / sutures Other skin conditions BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
General & Minor
PedIATRIC COT
Exposure to communicable disease Prescription / Medication request
Fever Ring removal
Hyperglycemia Abnormal lab values
Hypoglycemia Pallor / anemia
Direct referral for consultation Post-operative complications

Ped
mod
Inconsolable crying in infants

Critic
Dressing change look
CNS
Hemo
Imaging tests Congenital problem in children dyn
Resp
Medical device problem Minor complaints NOS Temp
Pain
Newly Born BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 001 Cardiac arrest (non traumatic)

Cardi
ac
arrest
Cardiac arrest
1
(non
traum
atic) (non-traumatic)
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 002 Cardiac arrest (traumatic)

Cardi
ac
arrest Cardiac arrest
1
(trau
matic) (traumatic)
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 003 Chest pain (cardiac features)

Chest
pain
(cardi pe
1 VS
ac
featur
es)
1 Shock
Chest Pain with cardiac 1 Unconscious (GCS 3-9)
features 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 004 Chest pain (non cardiac features)

Chest
pain
(non pe
1
cardia
c
featur 1 Severe respiratory distress
es) 1 Shock
2 VS, PS 1 Unconscious (GCS 3-9)
Other significant chest pain 2 Hemodynamic compromise
2
(ripping, tearing) 2 Altered level of consciousness (GCS 10 - 13)
2 <3 mos, T < 36C OR >38C
3 VS, PS, chronicity 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
4 VS, PS, chronicity 3 Vital signs outside the limits of normal
Ped
3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) mod
3 >36 mos, T >38.5C, & appearing unwell (toxic) Critic
5 Chest pain, non cardiac 4 >36 mos, T >38.5 C & appearing well (non-toxic)
look
CNS
2 Acute severe pain (8-10) Hemo
dyn
Note with chest wall pain the 3
3
Acute moderate pain ( 4- 7)
Chronic severe pain (8-10)
Resp
pain is peripheral 4 Acute mild pain ( < 4 ) Temp

Pain
5 Chronic mild pain ( < 4 )
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 005 Palpitations / Irregular heart beat

Palpit
ations
/ pe
1
Irregu
lar
heart 1 Severe respiratory distress
2
beat
VS 1 Shock
With chest pain cardiac 2 Moderate respiratory distress
features 2 Altered level of consciousness (GCS 10 - 13)
History or documented 2 <3 mos, T < 36C OR >38C
2 evidence of potential lethal 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
dysrhythmia 3 Mild respiratory distress
3 Vital signs outside the limits of normal Ped
mod
3 VS 3 >36 mos, T >38.5C, & appearing unwell (toxic)
Critic
look
CNS
3 Acute onset, ongoing Hemo
dyn
History of palpitations, Resp

4
presently resolved Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 006 Hypertension

Hyper
tensio
n
Ped
mod
In children blood pressure is a

Critic
 look
late indicator of a serious CNS

Hemo
circulatory volume problem dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 007 General weakness

Gener
pe
1
al
weak
VS, Severe dehydration Vital sign modifiers
ness 1 Severe respiratory distress
2 VS, Moderate dehydration 1 Shock
VS, Acute inability to
ambulate 2 Hemodynamic compromise
3 Mild dehydration 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
4 VS, Potential for dehydration 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
4 Chronic weakness 3 Vital signs outside the limits of normal
3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) Ped
mod
4 >36 mos, T >38.5 C & appearing well (non-toxic) look
If considering a CVA go to: CNS
Symptoms of a CVA Hemo

dyn
Resp
Temp
Pain
Go to Dehydration definition
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 008 Syncope / Pre-syncope

Synco
pe / pe
1
Pre- VS Vital sign modifiers
synco
2
pe VS 1 Shock
New onset dysrhythmia, 1 Unconscious (GCS 3-9)
2 irregular pulse &/or change in 2 Hemodynamic compromise
rate 2 Altered level of consciousness (GCS 10 - 13)
2 No prodromal symptoms 2 <3 mos, T < 36C OR >38C
2 Occurring during exercise 3 Mild respiratory distress
3 VS 3
3
Vital signs outside the limits of normal
3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) Ped
mod
With prodromal symptoms or 3 >36 mos, T >38.5C, & appearing unwell (toxic)
3 sudden position change
Critic
look
CNS
Normal vitals, symptoms
4 resolved
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 009 Edema, generalized

Edem
pe
1a,
gener
alized 1 Severe respiratory distress
2 VS 1 Shock
Edema, generalized, normal
vitals 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
3 Vital signs outside the limits of normal
3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) Ped
mod
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 010 Bilateral leg swelling / Edema

Bilate
ral leg
pe
2
swelli
ng /
VS, PS Vital sign modifiers
Edem
3a VS, PS 2 Hemodynamic compromise
4 VS, PS + chronicity 2 Altered level of consciousness (GCS 10 - 13)
Edema/bilateral leg 2 <3 mos, T < 36C OR >38C
5 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
swelling, chronic 3 Mild respiratory distress
4 >36 mos, T >38.5 C & appearing well (non-toxic) Ped
mod
Critic
2 Acute severe pain (8-10) look
3 Acute moderate pain ( 4- 7) CNS
3 Chronic severe pain (8-10) Hemo
4 Acute mild pain ( < 4 ) dyn
5 Chronic mild pain ( < 4 ) Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 011 Cool pulseless limb

Cool
pe
1
pulsel
ess
limb
2 Cool Pulseless Limb 1 Shock
2 <3 mos, T < 36C OR >38C
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 012 Unilateral reddened hot limb

Unilat
eral
2
redde
ned
VS, PS pe
hot
3
limb VS, PS 2 Moderate respiratory distress
3 Extensive inflammation 2 Altered level of consciousness (GCS 10 - 13)
4 Localized inflammation 2 <3 mos, T < 36C OR >38C
Other 1st order modifiers mod
Critic
3 Acute moderate pain ( 4- 7)
CNS
4 Acute mild pain ( < 4 )
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 051 Earache

pe
2
Earac
he
3 VS, PS, + Chronicity 2 Hemodynamic compromise
4 VS, PS, + Chronicity 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
5 PS + Chronicity 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
4 >36 mos, T >38.5 C & appearing well (non-toxic)
Ped
2 Acute severe pain (8-10) Critic
look
3 Chronic severe pain (8-10) CNS
4 Acute mild pain ( < 4 ) Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 052 Foreign body ear

Forei
pe
gn
Acute peripheral severe
2
body 2 Acute severe pain (8-10)
ear pain (8-10) 3 Acute moderate pain ( 4- 7)
Acute peripheral moderate
3
pain ( 4- 7)
Foreign body ear, mild pain
4
(<4)
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 053 Loss of hearing

Loss
3of
hearin
Hearing loss, sudden onset
g
5 Hearing loss, gradual onset
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 054 Tinnitus

Tinnit
Suspected aspirin
2
us
ingestion
4 Tinnitus
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 055 Discharge, ear

Disch
pe
2
arge,
ear
3 VS 2 <3 mos, T < 36C OR >38C
4 VS 3 Mild respiratory distress
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 056 Ear injury

pe
2
Ear
injury
2 Amputation 2 Hemodynamic compromise
3 VS, PS, BD 2 Fever, immunocompromised
Cold injury severe with 2 <3 mos, T < 36C OR >38C
blanching, cyanosis 3 Mild respiratory distress
4 VS, PS 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
Cold injury, minor with no
4 4 >36 mos, T >38.5 C & appearing well (non-toxic) Ped
discoloration Other 1st order modifiers
mod
Critic
Laceration requiring 3 Bleeding disorder (moderate or minor bleeds)
4 CNS
sutures 3 Acute moderate pain ( 4- 7) Hemo
dyn
Laceration/abrasion not Resp
5
requiring sutures Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 101 Dental / Gum problems

Denta
l/ pe
2
Gum PS 2 Acute severe pain (8-10)
proble
ms 3 Bleeding disorder (moderate or minor bleeds)
Dental avulsion (recent with 3 Acute moderate pain ( 4- 7)
2
intact tooth present) 3 Chronic severe pain (8-10)
3 PS + chronicity, BD
4 PS + chronicity
Dental/gum problem minor
5
problem Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 102 Facial trauma

Facial pe
1
a
2 VS, PS, MOI 1 Shock
3 VS, PS, BD 1 Unconscious (GCS 3-9)
4 VS, PS 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
mod
3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) Critic
3 >36 mos, T >38.5C, & appearing unwell (toxic) look
4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
2 High risk mechanism of injury dyn
2 Acute severe pain (8-10) Resp

4 Acute mild pain ( < 4 ) Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 103 Sore throat

pe
1
Sore
throat
2 VS, PS 1 Shock
Obvious edema/swelling of
lips, tongue or oropharynx 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
3 VS, PS 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
3 Difficulty swallowing 3 Vital signs outside the limits of normal Ped
4 VS, PS, chronicity 3 >36 mos, T >38.5C, & appearing unwell (toxic) Critic
look
Minor sore throat +/- CNS
laryngitis 2 Acute severe pain (8-10) Hemo
dyn
Resp
3 Chronic severe pain (8-10)
4 Acute mild pain ( < 4 ) Temp
4 Chronic moderate pain ( 4- 7) Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 104 Neck swelling / pain

Neck
1
swelli
ng /
VS pe
pain
2 VS, PS 1 Severe respiratory distress
1 Shock
Neck stiffness / 1 Unconscious (GCS 3-9)
meningismus +/- fever 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
Neck swelling/pain with 3 Vital signs outside the limits of normal Ped
5 chronic central mild pain 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) mod
Critic
(< 4) 3 >36 mos, T >38.5C, & appearing unwell (toxic) look
Hemo
2 Acute severe pain (8-10) dyn
3 Acute moderate pain ( 4- 7) Resp
Temp
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 105 Neck trauma

Neck
1
traum VS pe
a Vital sign modifiers
2 VS, PS, BD 1 Severe respiratory distress
1 Shock
Paresthesias, neurological 1 Unconscious (GCS 3-9)
signs 2 Hemodynamic compromise
2 Hoarseness and dysphasia 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
3 VS, PS, BD 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
4 VS, PS 3 Vital signs outside the limits of normal Ped
mod
look
dyn
Resp
2 High risk mechanism of injury Temp
Pain
4 Acute mild pain ( < 4 ) BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 106 Difficulty swallowing / Dysphagia

Difficu
lty
pe
1
swallo
wing /
Dysp 1 Severe respiratory distress
2
hagia VS, PS 1 Shock
2 Drooling or stridor 1 Unconscious (GCS 3-9)
3 Possible foreign body 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
look
CNS
Hemo
3 Acute moderate pain ( 4- 7) dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 107 Facial pain (non-traumatic / non-dental)

Facial
pain
(non- pe
2
traum
atic /
non- 2 Moderate respiratory distress
3
dental VS, PS, chronicity 2 Hemodynamic compromise
)
4 VS, PS, chronicity 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
5 PS, chronicity 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
Other 1st order modifiers Ped
mod
3 Acute moderate pain ( 4- 7) look
3 Chronic severe pain (8-10) CNS

dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 151 Epistaxis

pe
1
Epista
xis
2 VS, BD 1 Shock
2 Uncontrolled epistaxis 1 Unconscious (GCS 3-9)

(despite appropriate pressure) 2 Hemodynamic compromise
3 VS, BD 2 Fever, immunocompromised
Bleeding controlled with 2 <3 mos, T < 36C OR >38C
pressure 3 Mild respiratory distress
4 VS 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
Ped
mod
Critic
Acute epistaxis, no active
4 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
bleeding Other 1st order modifiers Hemo
dyn
Periodic / recurrent, no 3 Bleeding disorder (moderate or minor bleeds)
5 Resp
active bleeding Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 152 Nasal congestion / Hay fever

Nasal
conge
stion / Nasal congestion / hay
5Hay
fever fever
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 153 Foreign body, nose

pe
2 VS, PS
Foreign body,
nose Vital sign modifiers
Moderate respiratory 3 Mild respiratory distress
2 3 Vital signs outside the limits of normal
distress 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
3 VS, PS 4 >36 mos, T >38.5 C & appearing well (non-toxic)
4 VS, PS 2 Acute severe pain (8-10)
Foreign body, nose with
4 4 Acute mild pain ( < 4 )
acute mild pain Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 154 URTI complaints

URTI pe
2
compl VS, PS Vital sign modifiers
aints
3 VS, PS 3 Mild respiratory distress
4 VS, PS 3 Vital signs outside the limits of normal
5 Appears well, no fever 3 >36 mos, T >38.5C, & appearing unwell (toxic)
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 155 Nasal trauma

Nasal pe
2
traum VS, PS, BD Vital sign modifiers
a
Uncontrolled epistaxis 2 Hemodynamic compromise
2 (despite appropriate 2 Altered level of consciousness (GCS 10 - 13)
pressure) 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
5 PS 3 >36 mos, T >38.5C, & appearing unwell (toxic)
mod
Other 1st order modifiers Critic
2 Bleeding disorder (life or limb threatening bleed) look
2 Acute severe pain (8-10) CNS
dyn
4 Acute mild pain ( < 4 ) Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 201 Frostbite / Cold injury
2Frostbite
PS / pe
Cold injury 2 Acute severe pain (8-10)
2 Cold pulseless limb 3 Acute moderate pain ( 4- 7)
3 PS 4 Acute mild pain ( < 4 )
3 Blanching of skin 5 Chronic mild pain ( < 4 )
4 PS, chronicity
5 Frostbite/cold injury
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 202 Noxious inhalation

Noxio
pe
1 us
inhala
tion
2 VS 1 Shock
Smoke inhalation, or other, 2 Hemodynamic compromise
no distress 3 Mild respiratory distress
Remote exposure, no
4
symptoms
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 203 Electrical injury

Electri pe
1cal VS Vital sign modifiers
injury
2 VS, PS 1 Shock
2 Obvious cutaneous injury 2 Moderate respiratory distress
No obvious cutaneous 3 Mild respiratory distress
3 3 Vital signs outside the limits of normal
injury Other 1st order modifiers
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 204 Chemical exposure

Chem
pe
1
ical
expos
ure
1 Major burn >25% BSA 1 Shock
Major burn hand, feet, 1 Unconscious (GCS 3-9)
groin or face 2 Hemodynamic compromise
2 Symptomatic eye 'splash'
Ped
mod
The minimum level is 2 to BSA estimation Critic
look
ensure early decontamination CNS
and identification of the Hemo
dyn
substances as toxic or not Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 205 Hypothermia

Hypot pe
1
hermi VS Vital sign modifiers
a
2 VS 1 Shock
2 <3 mos, T < 36C OR >38C
3 Core temperature 32-35 °C 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
4 No frostbite, normal VS 3 Mild respiratory distress
mod
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 206 Near Drowning

Near pe
1 VS
Drow
ning
2 VS 1 Shock
2 <3 mos, T < 36C OR >38C
3 Core temperature 32-35 °C 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
mod
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 251 Abdominal pain

Abdo pe
1
pain
2 VS, PS 1 Shock
3 VS, PS, chronicity 1 Unconscious (GCS 3-9)
4 VS, PS, chronicity 2 Hemodynamic compromise
Chronic mild abdominal 2 Fever, immunocompromised
5 2 <3 mos, T < 36C OR >38C
pain
mod
dyn
3 Chronic severe pain (8-10) Temp
5 Chronic mild pain ( < 4 ) BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 252 Anorexia

pe
2
Anore
xia
3 Significant weight loss 2 Altered level of consciousness (GCS 10 - 13)
4 Anorexia, looks well 2 <3 mos, T < 36C OR >38C
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 253 Constipation

Const pe
2
ipatio VS, PS Vital sign modifiers
n
4 VS, PS, chronicity 2 Altered level of consciousness (GCS 10 - 13)
5 Simple constipation 2 <3 mos, T < 36C OR >38C
mod
dyn
4 Chronic moderate pain ( 4- 7) Resp
5 Chronic mild pain ( < 4 ) Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 254 Diarrhea

pe
1
Diarrh VS, severe dehydration
ea Vital sign modifiers
2 VS, moderate dehydration 1 Severe respiratory distress
1 Shock
Uncontrolled bloody 1 Unconscious (GCS 3-9)
3
diarrhea 2 Moderate respiratory distress
2 <3 mos, T < 36C OR >38C
Chronic diarrhea, normal 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
5
VS 3 Mild respiratory distress Ped
mod
Critic
3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) look
3 >36 mos, T >38.5C, & appearing unwell (toxic) CNS
4 >36 mos, T >38.5 C & appearing well (non-toxic) Hemo
If a BD exist with presence of bloody dyn
diarrhea then go to Resp
Blood in stool/melena Temp
Pain
Go to Dehydration definition BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 255 Foreign body in rectum

Forei
gn
pe
2
body
in
rectu
3m VS, PS 2 Moderate respiratory distress
4 VS, PS 2 Altered level of consciousness (GCS 10 - 13)
5 Foreign body in rectum 2 <3 mos, T < 36C OR >38C
3 >36 mos, T >38.5C, & appearing unwell (toxic) Ped
mod
Critic
Other 1st order modifiers look
2 Acute severe pain (8-10) CNS
3 Acute moderate pain ( 4- 7) Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 256 Groin pain / mass

Groin pe
2
pain / VS, PS Vital sign modifiers
mass
5 Groin pain / mass 2 <3 mos, T < 36C OR >38C
mod
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 257 Vomiting and/or nausea

Vomit
ing
pe
1
and/o
r
naus
Active significant 1 Severe respiratory distress
2ea
1 Shock
hematemesis 1 Unconscious (GCS 3-9)
2 VS, moderate dehydration 2 Moderate respiratory distress
Coffee ground emesis / 2 Altered level of consciousness (GCS 10 - 13)
melena 2 <3 mos, T < 36C OR >38C
3 VS, mild dehydration 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
VS, potential for 3 Vital signs outside the limits of normal Ped
4 mod
dehydration 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) Critic
Chronic vomiting and/or 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
5
nausea, normal VS Hemo
dyn
Go to Dehydration definition Resp
Temp
If a BD exist with presence of
Pain
Coffee ground emesis / melena go to
“Vomiting blood” BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 258 Rectal / Perineal pain

Recta
l/ pe
2
Perin VS, PS Vital sign modifiers
eal
3
pain
VS, PS, chronicity 2 Moderate respiratory distress
Chronic mild 2 <3 mos, T < 36C OR >38C
rectal/perineal pain 3 Mild respiratory distress
mod
dyn
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 259 Vomiting blood

Vomit pe
1
ing VS Vital sign modifiers
blood
2 VS 1 Shock
Active or significant 1 Unconscious (GCS 3-9)
hematemesis 2 Hemodynamic compromise
Coffee ground
emesis/melena 2 <3 mos, T < 36C OR >38C
Small amount, normal vital 3 Mild respiratory distress
3
signs 3 Vital signs outside the limits of normal Ped
mod
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 260 Blood in stool / Melena

Blood
in
pe
1
stool
/
Melen
2 a VS 1 Shock
Large amount of melena or 1 Unconscious (GCS 3-9)
rectal bleeding 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
Moderate amount of
melena or rectal bleeding 3 Mild respiratory distress
Rectal bleeding small 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
mod
4 Critic
amount 3 >36 mos, T >38.5C, & appearing unwell (toxic) look
dyn
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 261 Jaundice

pe
2
Jaun
dice
5 Jaundice, looks well 2 <3 mos, T < 36C OR >38C
mod
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 262 Hiccoughs

pe
2
Hicco
ughs
Fever, PS Vital sign modifiers
3 Fever (appears unwell), PS 2
2
Fever, immunocompromised
<3 mos, T < 36C OR >38C
Hiccoughs, chronic no 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
4 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
distress 3 >36 mos, T >38.5C, & appearing unwell (toxic)
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 263 Abdominal mass / distention

Abdo
minal
pe
1
mass
/
diste
2
ntion VS, PS 1 Shock
3 Persistent vomiting 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
Chronic abdominal 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
5
mass/distention, looks well 3 Mild respiratory distress
mod
dyn
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 264 Anal / Rectal trauma

Anal /
Recta pe
2 l VS, PS, BD Vital sign modifiers
traum
3 a
VS, PS, BD 2 Hemodynamic compromise
5 Anal/rectal trauma 2 <3 mos, T < 36C OR >38C
mod
Patients in shock from rectal 3 Acute moderate pain ( 4- 7)
CNS
Hemo
trauma should be 3 Bleeding disorder (moderate or minor bleeds) dyn
documented under 4 Acute mild pain ( < 4 ) Resp
“Major trauma-penetrating Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 265 Oral / Esophageal Foreign Body

Oral /
Esop
hage pe
1
al VS Vital sign modifiers
Forei
2
gn
Body
Drooling or stridor 1
1
Shock
2 Hoarseness and dysphasia 1 Unconscious (GCS 3-9)
2 <3 mos, T < 36C OR >38C
3 Persistent vomiting 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
Ped
No swallowing or mod
4 3 >36 mos, T >38.5C, & appearing unwell (toxic) Critic
respiratory difficulty 4 >36 mos, T >38.5 C & appearing well (non-toxic)
look

dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 601 Feeding difficulties in newborn

Feedi
ng
diffic pe
1
ulties VS Vital sign modifiers
in
2
newb
orn
1 Shock
2 Refusing oral feeds 1 Unconscious (GCS 3-9)
3 Decreased oral intake 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
Critic
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 602 Neonatal jaundice

Neon
pe
1
atal
jaund
ice
2 VS 1 Shock
2 Infant < 7 days of age 1 Unconscious (GCS 3-9)
3 Infant > 7 days of age 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 301 Flank pain

pe
1
Flank
pain
2 VS, PS 1 Severe respiratory distress
1 Shock
5 Chronic mild flank pain 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
mod
dyn
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 302 Hematuria

pe
1
Hema
turia
2 VS, PS, BD 1
1
Shock
3 VS, PS, BD, chronicity 1 Unconscious (GCS 3-9)
5 Chronic mild pain 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
Ped
look
CNS
dyn
Resp
Pain
4 Chronic moderate pain ( 4- 7) BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 303 Genital discharge / lesion

Genit
al
pe
3
disch
arge /
VS, PS, chronicity Vital sign modifiers
lesio
4n VS, PS, chronicity 3 Vital signs outside the limits of normal
5 Genital discharge / lesion 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
5 Chronic mild pain ( < 4 ) Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 304 Penile swelling

Penil
pe
2e
swelli
Priapism Vital sign modifiers
ng
Paraphimosis (retracted 2 Moderate respiratory distress
foreskin, unable to reduce) 2 Altered level of consciousness (GCS 10 - 13)
2 <3 mos, T < 36C OR >38C
Penile Swelling, mild or
5 3 >36 mos, T >38.5C, & appearing unwell (toxic)
chronic pain 4 >36 mos, T >38.5 C & appearing well (non-toxic) Ped
mod
dyn
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 305 Scrotal pain and/or swelling

Scrot
al
pain pe
2
and/o VS, PS Vital sign modifiers
r
3
swelli
ng
VS, PS, chronicity 2 Hemodynamic compromise
Scrotal pain and/or 2 <3 mos, T < 36C OR >38C
swelling 3 Mild respiratory distress
mod
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 306 Urinary retention

Urina
pe
2ry
retent
ion
3 VS, PS, chronicity 2 <3 mos, T < 36C OR >38C
4 Urinary retention 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
If the patient is unstable 4 Acute mild pain ( < 4 ) Ped
mod
choose another complaint 5 Chronic mild pain ( < 4 )
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 307 UTI complaints

UTI pe
2
comp VS, PS Vital sign modifiers
laints
2 <3 mos, T < 36C OR >38C
Chronic, mild UTI
complaints/symptoms 3 Mild respiratory distress
Ped
look
CNS
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 308 Oliguria

pe
1
Oligu
ria
2 VS, PS 1 Shock
4 Oliguria 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
mod
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 309 Polyuria

pe
1
Polyu
ria
2 VS, PS 1 Shock
4 Polyuria 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
mod
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 310 Genital trauma

Genit
pe
1al
traum
a
2 VS, PS, BD 1 Shock
3 Sexual assault, stable 1 Unconscious (GCS 3-9)
3 VS, PS, BD 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
5 Genital trauma, no pain 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
mod
dyn
3 Acute moderate pain ( 4- 7) Temp
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 351 Depression / Suicidal / Deliberate self harm

Depression /
attempted suicide or clear
Suicidal /
2Deliberate
suicide plan
self harm Suicide Self injurious behavior with a non fatal
attempt outcome accompanied by evidence (explicit or
2 active suicidal intent implicit) that the person attempted to die.
uncertain flight or safety Suicide intent Subjective expectation and desire for self-
2 destructive act that would end in death.
risk
Suicidal Thought of serving as an agent of one’s own
ideation death, may vary in seriousness depending on
3 suicidal ideation, no plan specificity of plans and degree of suicidal
intent.
depressed, no suicidal
4 Uncertain Patients threatening violence towards
ideation themselves or others; patients exhibiting
Ped
mod
flight or
uncontrolled anger, restlessness, paranoia, or Critic
safety risk look
hallucinatory behavior; or patients unable or
unwilling to cooperate with suicide risk CNS
Note: In Quebec this complaint is assessment and who pose a flight risk. Need Hemo
close observation based on site resources. dyn
separated in 3 distinct complaints (If family member willing to observe & both Resp
Temp
observation may not be required.)
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Anxie
PedIATRIC COT
system
Coding
352 Anxiety / Situational crisis

ty /
NACRS Code Situat
ional
crisis
2 severe anxiety / agitation Anxiety / Definition

Agitation
2 uncertain flight or safety risk
Severe Extreme unease, apprehension or worry with
signs of excessive circulating catecholamines;
3 moderate anxiety / agitation anxiety /
or dangerously agitated and uncooperative and
agitation does not calm down when asked
4 mild anxiety / agitation
Moderate Clear unease, apprehension, or worry, but no
anxiety / obvious tachycardia or tremulousness; or signs
of agitation, and does not consistently obey
agitation commands (e.g. will sit or calm down when
asked, but soon becomes restless and agitated
again Ped
mod
Mild Mild unease, apprehension or worry, but can be Critic
look
anxiety / reassured; or restless but cooperative; obeys
commands. CNS
agitation
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 353 Hallucinations / Delusions

pe
2 VS
Hallucination Vital sign modifiers
s / Delusions 2 Moderate respiratory distress
acute psychosis, severe anxiety / agitation ,
2 uncertain flight or safety risk
2
2
Hemodynamic compromise
Altered level of consciousness (GCS 10 - 13)
VS, moderate anxiety / agitation or with
3 paranoia
2
2
<3 mos, T < 36C OR >38C
3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
4 VS, mild agitation, stable 3 Vital signs outside the limits of normal
5 mild anxiety / agitation, chronic hallucinations 3 >36 mos, T >38.5C, & appearing unwell (toxic)
Hallucination / Delusion Definition

Ped
Acute psychosis May present with extreme self neglect, disordered or racing thoughts or both, speech pattern mod
impairments, impaired reality testing with ‘lack of insight’, may be responding to hallucinatory or Critic
look
delusional thoughts or both, which may be accompanied by hostility.
CNS
Paranoia Delusions of a persecutory nature - being followed, poisoned, or harmed in some way. Ideas of Hemo
reference - the belief that people are talking about you. May be accompanied by extreme fear, dyn
agitation or hostility. Resp
Chronic Known history of hallucinations with no recent change in nature, and/or frequency, or in Temp
hallucinations patient’s level of distress related to them.
Pain
Chronic, non-urgent Patient is well known to the ED and triage nurse with a recurrent complaint that has either been
condition fully dealt with, or patient is just looking for food, warmth or temporary shelter. BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 354 Insomnia
4
Inso
mnia
Acute insomnia
5 Chronic insomnia
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 355 Violent / Homicidal behaviour

Viole
nt /
Homi
imminent harm to self or
1
cidal
beha
viour
others or specific plans
2
risk
3 violent ideation, no plan
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 356 Social problem

Socia
l
abuse physical, mental,
3
probl
em high emotional stress
4 unable to cope
chronic, non urgent
5
condition
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 357 Bizarre behaviour

pe
1Bizarre
uncontrolled Vital sign modifiers
behaviour

uncertain flight or safety 2 Altered level of consciousness (GCS 10 - 13)
risk 2 <3 mos, T < 36C OR >38C
3 VS
3 controlled 3 Vital signs outside the limits of normal
4 VS 3 >36 mos, T >38.5C, & appearing unwell (toxic)
mod
4 harmless behaviour Critic
look
chronic, non urgent CNS

5
condition Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 608 Concern for patient's welfare

Conc
ern
for
Conflict or unstable Complaint to be used for
1
patie
nt's
welfa situation patients in whom the nurse
re
Risk of flight or ongoing suspects abuse or neglect
2
abuse and there is no acute
3 Physical or sexual assault medical problem.
History/signs of abuse or
4
maltreatment
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
607 Paediatric Disruptive behaviour
Code
NACRS
Pedia
tric
Disru
2
ptive
beha
viour
risk/family distress
Acute difficulties with
3
others/environment
Persistent problematic
4
behavior
Chronic, unchanged
5
behavior Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 401 Altered level of consciousness

Altere
d
level pe
1 VS
of
cons
2 VS, MOI
cious
ness 1 Shock
BS<3 mmol/L &/or 1 Unconscious (GCS 3-9)
2 <3 mos, T < 36C OR >38C
mod
2 High risk mechanism of injury Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 402 Confusion

pe
1Conf VS
usion Vital sign modifiers
1 Shock
BS <3 mmol/L &/or 1 Unconscious (GCS 3-9)
symptomatic
acute , with headache or 2 Altered level of consciousness (GCS 10 - 13)
altered LOC 2 <3 mos, T < 36C OR >38C
3 VS 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
acute without headache or 3 Vital signs outside the limits of normal Ped
3 mod
altered LOC 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
Critic
chronic, no change from CNS

4
usual state Hemo
dyn
Resp
Temp
LOC on this slide = Level of consciousness
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 403 Vertigo

pe
1
Vertig
o
2 VS 1 Shock
not positional +/- other 1 Unconscious (GCS 3-9)
neurological findings 2 Hemodynamic compromise
positional, no other neuro
symptoms 2 <3 mos, T < 36C OR >38C
mod
Critic
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 404 Headache

pe
1
Head
ache
2 sudden, severe, worst ever 1 Shock
visual acuity disturbance 1 Unconscious (GCS 3-9)
+/- eye pain 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
4 VS, PS, chronicity 3 Mild respiratory distress
mod
Chronic or recurring 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
Critic
look
headache 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
dyn
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 405 Seizure

pe
1
Seizu
re
Actively seizing Vital sign modifiers
1 VS 1 Shock
2 Post-ictal 2 Moderate respiratory distress
Resolved, normal level of 2 Fever, immunocompromised
3 2 <3 mos, T < 36C OR >38C
alertness 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
Ped
look
CNS
3 Acute moderate pain ( 4- 7) Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 406 Gait disturbance / Ataxia

Gait
distur
pe
1
banc
e/
Ataxi
2a Time of onset < 3 hrs 1 Severe respiratory distress
1 Shock
2 <3 mos, T < 36C OR >38C
If considering a CVA go to: 3 Mild respiratory distress
Symptoms of a CVA 3 Vital signs outside the limits of normal Ped
mod
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 407 Head injury

pe
1
Head
injury
2 VS, PS, BD, MOI 1 Shock
New focal neurologic 1 Unconscious (GCS 3-9)
findings 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
3 History of LOC 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
Prolonged spinal 3 Mild respiratory distress
3 3 Vital signs outside the limits of normal Ped
immobilization 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
mod
Critic
4 No history of LOC 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
dyn
LOC on this slide is Loss of consciousness 3 Acute moderate pain ( 4- 7)
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 408 Tremor

pe
2
Trem VS
or Vital sign modifiers
4 Chronic tremor 2 Altered level of consciousness (GCS 10 - 13)
2 <3 mos, T < 36C OR >38C
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
Extre
NACRS Code 409 Extremity weakness / Symptoms of CVA
mity
weak
ness pe
Symp
2
toms
of
VS, PS, BD 1 Severe respiratory distress
1 Shock
CVA
2 Time of onset < 3 hours 1 Unconscious (GCS 3-9)
3 VS, PS, BD 2 Hemodynamic compromise
3 > 3 hours or resolved 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
May use pain scales if 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
mod
Critic
headache is present 3 >36 mos, T >38.5C, & appearing unwell (toxic) look
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 410 Sensory loss / Parasthesias

Sens
ory
loss /
New onset sensory
3
Paras
thesi
as
loss/paresthesias
Chronic sensory
4
loss/paresthesias

Symptoms of a CVA Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 609 Floppy child

Flopp pe
1y VS Vital sign modifiers
child
2 VS, BD 1 Shock
No tone, unable to support
head 2 Hemodynamic compromise
Limited/less than expected 2 Fever, immunocompromised
3
muscle tone 2 <3 mos, T < 36C OR >38C
Ped
look

dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 451 Menstrual problems

Mens
pe
1
trual
probl
ems
2 VS, PS 1 Shock
4 Menstrual problems 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
This implies symptoms 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
normally associated with 3 Vital signs outside the limits of normal Ped
mod
menses 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) Critic
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 452 Foreign body, vagina

Forei
gn pe
1
body, VS Vital sign modifiers
vagin
2a VS, PS 1 Severe respiratory distress
1 Shock
5 Foreign body, vagina 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
mod
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 453 Vaginal discharge

Vagin
pe
2al
disch
arge
5 Mild symptoms 2 <3 mos, T < 36C OR >38C
mod
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 454 Sexual assault

Sexu
pe
1
al
assa
ult
2 VS, PS 1 Shock
2 < 2 hours 1 Unconscious (GCS 3-9)
3 >= 2 hours and < 12 hours 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
4 >= 12 hours; no injury 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
mod
Suggested not to post this 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) Critic
complaint on the tracking 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
screen or board, but choose a Other 1st order modifiers Hemo
dyn
non offensive code word. 3 Acute moderate pain ( 4- 7) Resp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 455 Vaginal bleed

Vagin
1al VS pe
bleed
2 VS, PSC, BD 1 Severe respiratory distress
1 Shock
2
Vaginal bleeding – 2 <3 mos, T < 36C OR >38C
normal VS 3 Mild respiratory distress
Vaginal bleeding - 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) mod
4 Critic
minor/spotting 3 >36 mos, T >38.5C, & appearing unwell (toxic) look
CNS
Hemo
Resp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 456 Labial swelling

Labia
2l
swelli
VS, PS pe
ng
3 VS, PS 2 Moderate respiratory distress
5 Labial swelling 2 <3 mos, T < 36C OR >38C
Critic
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 460 Vaginal pain / itch

Vagin
pe
2 PS
al
pain / Other 1st order modifiers
itch 2 Acute severe pain (8-10)
3 PS 3 Acute moderate pain ( 4- 7)
4 Vaginal pain, itch 4 Acute mild pain ( < 4 )
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 458 Pregnancy issues > 20 wks

Pregn
1ancy
VS pe
issue
s > 20
Presenting fetal parts, prolapsed 1 Severe respiratory distress
1wks
cord 1 Shock
1 Vaginal bleeding 3rd trimester 1 Unconscious (GCS 3-9)
2 VS, PS, BD, MOI 2 Hemodynamic compromise
2 Active labor (contractions <2 min) 2 Altered level of consciousness (GCS 10 - 13)
Pregnancy issues > 20 weeks no 2 <3 mos, T < 36C OR >38C
2
fetal movement / no fetal heart tones 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
Pregnancy issues > 20 weeks 3 Mild respiratory distress
2 headache+/- edema+/- abdo pain+/- 3 Vital signs outside the limits of normal Ped
mod
hypertension 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) Critic
2 Post delivery 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
3 VS, PS, BD Other 1st order modifiers Hemo

dyn
3 Active labor (contractions > 2 min) 2 Bleeding disorder (life or limb threatening bleed) Resp
Pregnancy issues > 20 weeks 2 High risk mechanism of injury Temp

3 3 Acute moderate pain ( 4- 7)
possible leaking amniotic fluid Pain
4 Pregnancy issues > 20 weeks 4 Acute mild pain ( < 4 ) BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 457 Pregnancy issues < 20 wks

Pregn
ancy pe
1
issue VS Vital sign modifiers
s < 20
2
wks VS, PS, BD 1 Severe respiratory distress
1 Shock
2
Vaginal bleeding - normal 2 Altered level of consciousness (GCS 10 - 13)
VS 2 <3 mos, T < 36C OR >38C
Vaginal bleeding - minor / 3 Vital signs outside the limits of normal Ped
4 mod
spotting 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) Critic
Pregnancy issues < 20 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
weeks Hemo
dyn
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 502 Chemical exposure, eye
2
ChemicalChemical exposure, eye
exposure, eye
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 503 Foreign body, eye

Forei
pe
2
gn
body,
PS Other 1st order modifiers
eye 2 Acute severe pain (8-10)
2 Penetrating foreign body 3 Acute moderate pain ( 4- 7)
Acute or abrupt change in 4 Acute mild pain ( < 4 )
2
vision
3 PS
4 PS
5 Acute peripheral mild pain
Ped
mod
Critic
look
CNS
Hemo
This includes corneal dyn
Resp
abrasions and corneal foreign
Temp
body
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 504 Visual disturbance
acute or abrupt change in

Visual
2
disturbance
vision
chronic/gradual change in
4
vision
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 505 Eye pain

pe
2
Eye
pain
vision 3 Chronic severe pain (8-10)
3 PS, Chronicity 4 Chronic moderate pain ( 4- 7)
4 PS, Chronicity
5 Eye pain, chronic
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 506 Red Eye, discharge

Red
pe
2
Eye,
disch
arge 2 Acute severe pain (8-10)
3 PS, Chronicity 3 Acute moderate pain ( 4- 7)
4 Red eye / discharge, acute 3 Chronic severe pain (8-10)
4 PS, Chronicity 5 Chronic mild pain ( < 4 )
Red eye / discharge,

5
chronic
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 507 Photophobia

Photo pe
2
phobi PS Other 1st order modifiers
a
4 Photophobia 4 Acute mild pain ( < 4 )
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 508 Diplopia
3
Diplopia
Acute onset
4 Chronic diplopia

Symptoms of a CVA
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 509 Periorbital swelling

Perio
pe
2
rbital
swelli
ng
5 Periorbital swelling 2 <3 mos, T < 36C OR >38C
mod
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 510 Eye trauma

Eye pe
2
traum PS, BD, MOI Other 1st order modifiers
a
Penetrating injury, 2 Bleeding disorder (life or limb threatening bleed)
2 chemical or direct thermal 2 High risk mechanism of injury
burn 3 Acute moderate pain ( 4- 7)
Blunt mechanism of injury 4 Acute mild pain ( < 4 )
2
with visual loss
2
vision Ped
mod
Nurse unable to visualize Critic

2 look
eye CNS
Hemo
3 PS, BD, MOI dyn
Resp
Eye trauma, Acute mild
4 Temp
pain (< 4) Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 511 Re-check eye

Re- pe
2
chec PS Other 1st order modifiers
k eye
vision 4 Acute mild pain ( < 4 )
3 PS
4 PS
5 Re-check eye
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 551 Back pain

pe
1
Back
pain
Neuro-deficit +/- bowel
2 1 Shock
bladder problems 1 Unconscious (GCS 3-9)
2 <3 mos, T < 36C OR >38C
5 Back pain 3 Mild respiratory distress
mod
Paeds: 2nd Step Hemo
dyn
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 552 Traumatic back / spine injury

Trau
matic
pe
1
back
/
spine
injury Neuro-deficit +/- bowel
2 1 Shock
bladder problems 1 Unconscious (GCS 3-9)
2 VS, PS, BD, MOI 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
Traumatic back/spine
injury, mild central pain 3 Mild respiratory distress
mod
dyn
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 553 Amputation

pe
1
Ampu
tation
Traumatic amputation of an
1 1 Shock
extremity. 1 Unconscious (GCS 3-9)
2 VS, MOI, BD 2 Hemodynamic compromise
Traumatic amputation of a
digit. 2 <3 mos, T < 36C OR >38C
3 Amputation 3 Mild respiratory distress
mod

2 Acute severe pain (8-10) Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 556 Upper extremity injury

Uppe
r pe
1
mity
2
injury
VS, PS, MOI, BD 1 Shock
Open fracture or neuro-
vascular compromise 2 Hemodynamic compromise
3 Obvious deformity 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
vascular compromise 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) mod
Critic
4 VS, PS, Chronicity 4 >36 mos, T >38.5 C & appearing well (non-toxic)
CNS
Tight cast with no neuro- 2 Bleeding disorder (life or limb threatening bleed)
Hemo
4 dyn
vascular compromise 2 High risk mechanism of injury Resp
Upper extremity trauma, 3 Bleeding disorder (moderate or minor bleeds) Temp
chronic mild pain 3 Chronic severe pain (8-10)
Pain
5 Chronic mild pain ( < 4 ) MOI

Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 557 Lower extremity injury

Lowe
r pe
1
mity
2
injury
VS, PS, MOI, BD 1 Shock
Open fracture or neuro-
vascular compromise 2 Hemodynamic compromise
3 Obvious deformity 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
Critic
4 VS, PS, Chronicity 4 >36 mos, T >38.5 C & appearing well (non-toxic)
CNS
Tight cast with no neuro- 2 Bleeding disorder (life or limb threatening bleed)
Hemo
4 dyn
vascular compromise 2 High risk mechanism of injury Resp
Lower extremity trauma, 3 Bleeding disorder (moderate or minor bleeds) Temp
chronic mild pain 3 Chronic severe pain (8-10)
Pain
5 Chronic mild pain ( < 4 ) MOI

Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 554 Upper extremity pain

Uppe
r pe
1
mity
2
pain
VS, PS, BD 1 Shock
Neuro-vascular
compromise 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
Tight cast with neuro- 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
3
vascular compromise 3 Mild respiratory distress
Ped
4 VS, PS, Chronicity 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) mod
look
Tight cast with no neuro- 4 >36 mos, T >38.5 C & appearing well (non-toxic)
4 Other 1st order modifiers CNS
vascular compromise 2 Bleeding disorder (life or limb threatening bleed) Hemo
dyn
Upper extremity chronic Resp
mild pain 3 Chronic severe pain (8-10) Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 555 Lower extremity pain

Lowe
r pe
1
mity
2
pain
VS, PS, BD 1 Shock
3 VS, PS 2 Moderate respiratory distress
vascular compromise 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
4 VS, PS, Chronicity 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
Tight cast with no neuro- 3 Vital signs outside the limits of normal
4 Ped
look
5 PS, Chronicity 4 >36 mos, T >38.5 C & appearing well (non-toxic)
CNS
Lower extremity chronic 2 Bleeding disorder (life or limb threatening bleed) Hemo
5 2 Acute severe pain (8-10)
dyn
mild pain 3 Acute moderate pain ( 4- 7) Resp

Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 558 Joint(s) swelling

Joint(
2s)
swelli
VS, PS pe
ng
3 VS, PS, BD, Chronicity 2 Moderate respiratory distress
4 VS, PS, Chronicity 2 Altered level of consciousness (GCS 10 - 13)
5 PS, Chronicity 2 <3 mos, T < 36C OR >38C
5 Joint swelling 3 Mild respiratory distress
Ped
look

dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 605 Paediatric gait disorder / painful walk

Pedia
tric
gait
pe
2
disor
der /
VS, PS, BD Vital sign modifiers
painf
3ul VS, PS, BD 2 Fever, immunocompromised
walk 2 <3 mos, T < 36C OR >38C
3 Limp problems with fever 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
4 VS, PS 3 >36 mos, T >38.5C, & appearing unwell (toxic)
4 Walking with difficulty Other 1st order modifiers
5 PS, Chronicity 2 Acute severe pain (8-10)
Ped
3 Acute moderate pain ( 4- 7) mod
3 Chronic severe pain (8-10) Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 858 Cast check

Cast pe Other 1st order modifiers
2
chec PS 2 Acute severe pain (8-10)
k
3
vascular compromise
4 PS
Tight cast with no neuro-
4
vascular compromise
5 Cast check or cast change Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 651 Shortness of breath

Short
ness pe
1
of VS Vital sign modifiers
breat
2
h
VS
1 Shock
Known asthmatic with FEV1 or 2 Moderate respiratory distress
2 PEFR <40% predicted (severe) 2 Hemodynamic compromise
3 VS
2 <3 mos, T < 36C OR >38C
Known asthmatic with FEV1 or 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
3 PEFR 40-60% predicted 3 Vital signs outside the limits of normal Ped
(moderate) 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
mod
Critic
4 VS 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
Hemo
Known asthmatic with FEV1 or dyn
4 PEFR >60% predicted (mild) Resp
Temp
SOB - shortness of breath, in

4 no distress
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 652 Respiratory arrest

Respi
1
ratory
arrest
Respiratory arrest
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 653 Cough / Congestion

Coug
h/ pe
2
Cong
estio
n 2 Moderate respiratory distress
4 VS 2 <3 mos, T < 36C OR >38C
Chronic cough / 3 Mild respiratory distress
5 congestion with normal 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
vital signs 3 >36 mos, T >38.5C, & appearing unwell (toxic)
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 654 Hyperventilation

Hyper pe
1
ventil VS Vital sign modifiers
ation
2 VS 1 Shock
Hyperventilation resolved, 2 Hemodynamic compromise
appears well 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
mod
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 655 Hemoptysis

Hemo pe
1
ptysi VS Vital sign modifiers
s
2 VS, BD 1 Shock
3 VS, BD 2 Moderate respiratory distress
4 Hemoptysis, appears well 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
mod
dyn
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 656 Respiratory foreign body

Respi
ratory pe
1
foreig VS Vital sign modifiers
n
2
body VS, PS 1 Severe respiratory distress
1 Shock
2 Drooling or stridor 1 Unconscious (GCS 3-9)
Hoarseness and 2 Hemodynamic compromise
2
dysphasia 2 Altered level of consciousness (GCS 10 - 13)
3 VS, PS 2 <3 mos, T < 36C OR >38C
No distress but with
difficulty swallowing 3 Vital signs outside the limits of normal Ped
mod
Respiratory - foreign body, 3 >36 mos, T >38.5C, & appearing unwell (toxic)
Critic
look
4 mild pain, appears in no 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
distress Hemo
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 657 Allergic reaction

Allerg
pe
1ic
reacti
on
2 VS, PS 1 Shock
2 <3 mos, T < 36C OR >38C
Hay fever causing nasal 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
5
congestion 3 Mild respiratory distress
mod
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 610 Stridor

pe
1
Strid
or
1 Airway compromise 1 Shock
2 Marked stridor 2 Hemodynamic compromise
3 Audible stridor 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
Ped
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 604 Wheezing – no other complaints

Whee
zing
pe
1
– no
other
comp 1 Severe respiratory distress
2
laints VS 1 Shock
Wheezing – no other 1 Unconscious (GCS 3-9)
complaints 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
Ped
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 606 Apneic spells in infants

Apnei
c
pe
1
spell
s in
infant 1 Severe respiratory distress
Apneic episode on
1 s
1 Shock
presentation 1 Unconscious (GCS 3-9)
2 Infant < 7 days of age 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
Recent spell consistent 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
2 with apnea or respiratory 3 Mild respiratory distress
compromise 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) Ped
mod
3 VS Critic
look
History of spell consistent CNS

3
with apnea Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 701 Bite

pe
1
Bite VS Vital sign modifiers
2 VS, PS 1 Shock
2 Previous severe reaction
2 <3 mos, T < 36C OR >38C
5 Minor bite 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
mod
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 702 Sting

pe
1
Sting VS Vital sign modifiers
2 VS, PS 1 Shock
2 <3 mos, T < 36C OR >38C
5 Sting 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
mod
dyn
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 703 Abrasion

pe Other 1st order modifiers
2
Abras
ion
PS 2 Acute severe pain (8-10)
4 Minor abrasion
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 704 Laceration / Puncture

Lacer
ation pe
Punct
2
ure
VS, PS, BD 1 Shock
Complex wound with 1 Unconscious (GCS 3-9)
neurovascular compromise 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
3 Active bleeding 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
mod
Bleeding 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
Critic
look
resolved/controlled 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
4 Sutures required 2 Bleeding disorder (life or limb threatening bleed)
Hemo
dyn
5 No sutures required 2 Acute severe pain (8-10) Resp

BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 705 Burn

pe
1
Burn VS Vital sign modifiers
2 VS, PS 1 Shock
2 Burn >25% Body surface area 1 Unconscious (GCS 3-9)

(BSA) 2 Hemodynamic compromise
Partial/full thickness to
hands, feet, face, perineum 2 <3 mos, T < 36C OR >38C
3 Burn 5 -25% BSA 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
Ped
mod
Critic
4 VS, PS look
<5% BSA Full; or Other 1st order modifiers Hemo

4 2 Acute severe pain (8-10) dyn
<10% BSA partial thickness 3 Acute moderate pain ( 4- 7) Resp

5 Painless minor burn Temp
Pain
BSA estimation
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 706 Blood and body fluid exposure

Blood
and
body
fluid High risk exposure:
expo
sure defined as needle stick,
hollow bore needle,
2 known or suspected HIV
or
hepatitis +ve source
High risk unless known
low risk source
Ped
mod
Low risk exposure: Critic

look
defined as non hollow CNS

Hemo
3 bore needle or dyn
fluid splash from low risk Resp
source Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 707 Pruritus

pe
3
Prurit
is
5 Pruritis
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 708 Rash

pe
2
Rash VS, PS Vital sign modifiers
Facial cellulitis,
particularly periorbital area 2 Altered level of consciousness (GCS 10 - 13)
Purpuric or petechial rash; 2 <3 mos, T < 36C OR >38C
2
appears ill 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
4 VS, PS 3 >36 mos, T >38.5C, & appearing unwell (toxic)
4 Localized cellulitis Other 1st order modifiers
mod
Critic
5 Localized rash 3 Acute moderate pain ( 4- 7) CNS
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 709 Localized swelling / redness

Local
ized
pe
1
swelli
ng /
redne
2ss VS, PS 1 Shock
Facial cellulitis, 1 Unconscious (GCS 3-9)
particularly periorbital area 2 Hemodynamic compromise
Purpuric or petechial rash;
appears ill 2 <3 mos, T < 36C OR >38C
4 VS, PS 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
mod
Critic
4 Localized cellulitis 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
5 Localized rash 2 Acute severe pain (8-10)
Hemo
dyn

Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 710 Wound check

Woun
pe
3
d
chec
k 3 Mild respiratory distress
5 Wound check 3
3
3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
>36 mos, T >38.5C, & appearing unwell (toxic)
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 711 Other skin conditions

Other
pe
3
skin
condi
tions 3 Mild respiratory distress
5 Other skin conditions 3
3
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 712 Lumps, bumps, calluses

Lump
s,
pe
2
bump
s,
callu
3
ses VS, PS 2 Hemodynamic compromise
5 Lumps, bumps calluses 2 <3 mos, T < 36C OR >38C
mod
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 713 Redness / tenderness, breast

Redn
ess /
tende pe
2
rness VS, PS Vital sign modifiers
,
3
breas
t
VS, PS 2 Hemodynamic compromise
Redness / tenderness, 2 <3 mos, T < 36C OR >38C
breast 3 Mild respiratory distress
mod
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 714 Rule out infestation

Rule
pe
3
out
infest
ation 3 Acute moderate pain ( 4- 7)
5 Rule out infestation
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 715 Cyanosis

pe
1
Cyan
osis
2 VS 1 Shock
3 Cyanosis 1 Unconscious (GCS 3-9)
2 <3 mos, T < 36C OR >38C
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 716 Spontaneous bruising

Spont
aneo pe
1
us VS Vital sign modifiers
bruisi
2
ng
VS, BD 1 Shock
3 Spontaneous bruising 1 Unconscious (GCS 3-9)
2 <3 mos, T < 36C OR >38C
mod
dyn
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 717 Foreign body, skin

Forei
pe
3
gn
body,
skin 3 Mild respiratory distress
5 Foreign body, skin 3
3
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 857 Removal staples / sutures

Remo
val
pe
3
stapl
es /
sutur
4es VS, PS 3 Mild respiratory distress
Removal of staples / 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
sutures 4 >36 mos, T >38.5 C & appearing well (non-toxic)
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 751 Substance misuse / Intoxication

Subst
ance
misu pe
1se / VS Vital sign modifiers
Intoxi
2
catio
n
1 Shock
2
Uncertain flight or safety 2 Altered level of consciousness (GCS 10 - 13)
4 Known low risk substance 3 Vital signs outside the limits of normal Ped
mod
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 752 Overdose ingestion

Over
pe
1
dose
inges
tion
2 VS 1 Shock
unknown substance 2 Hemodynamic compromise
Attempted suicide, clear 3 Mild respiratory distress
2
plan 3 Vital signs outside the limits of normal Ped
mod
3 VS 3 >36 mos, T >38.5C, & appearing unwell (toxic) look
3 Suicidal ideation, no plan Hemo
dyn
4 Overdose ingestion Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 753 Substance withdrawal

Subst
pe
1
ance
withd
rawal
1 Actively seizing 1 Shock
Recent seizures, post ictal, 2 Hemodynamic compromise
agitated 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
risk 3 Mild respiratory distress
2 Severe anxiety/agitation 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
mod
Critic
3 VS 4 >36 mos, T >38.5 C & appearing well (non-toxic) CNS
3 Moderate anxiety/agitation Hemo

dyn
4 Mild anxiety/agitation Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 801 Major trauma – penetrating

Major
traum pe
1a– VS, PS Vital sign modifiers
penet
2
rating VS, PS, MOI, BD 1 Severe respiratory distress
1 Shock
Neurovascular 1 Unconscious (GCS 3-9)
2
compromise of extremity 2 Moderate respiratory distress
Penetrating head, chest, 2 Altered level of consciousness (GCS 10 - 13)
abdomen 2 <3 mos, T < 36C OR >38C
3 Major trauma - penetrating 3 Vital signs outside the limits of normal Ped
mod

Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 802 Major trauma – blunt

Major
pe
1
traum
a–
blunt
2 VS, PS, MOI, BD 1 Severe respiratory distress
1 Shock
Neurovascular compromise 1 Unconscious (GCS 3-9)
2
of extremity 2 Moderate respiratory distress
Prolonged spinal 2 Altered level of consciousness (GCS 10 - 13)
immobilization 2 <3 mos, T < 36C OR >38C
4 Major trauma-blunt 3 Vital signs outside the limits of normal Ped
mod
dyn
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 803 Isolated chest trauma – penetrating

Isolat
ed
chest pe
1
a–
2
penet
rating
VS, PS, BD 1 Severe respiratory distress
1 Shock
Isolated chest trauma - 1 Unconscious (GCS 3-9)
penetrating
2 <3 mos, T < 36C OR >38C
2 Acute severe pain (8-10) Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 804 Isolated chest trauma – blunt

Isolat
ed
pe
1
chest
traum
a– 1 Severe respiratory distress
2
blunt VS, PS, BD, MOI 1 Shock
3 VS, PS, BD 2 Moderate respiratory distress
blunt (appears well) 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
Ped
look

dyn
Resp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 805 Isolated abdominal trauma – penetrating

Isolat
ed
abdo
pe
1
minal
traum
a–
2
penet VS, PS, BD, MOI 1 Severe respiratory distress
rating 1 Shock
Isolated abdominal trauma 1 Unconscious (GCS 3-9)
2
- penetrating 2 Moderate respiratory distress
2 <3 mos, T < 36C OR >38C
2 Acute severe pain (8-10) Ped
mod
2 Bleeding disorder (life or limb threatening bleed) Critic
2 High risk mechanism of injury look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 806 Isolated abdominal trauma – blunt

Isolat
ed
abdo pe
1
traum
2a–
blunt
VS, PS, BD, MOI 1 Shock
3 VS, PS, BD 1 Unconscious (GCS 3-9)
Isolated abdominal blunt 2 Hemodynamic compromise
trauma 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
mod
dyn
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 851 Exposure to communicable disease

Expo
sure
to
com
Exposure to
5
muni
cable
disea
communicable disease
se
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 852 Fever

pe
1
Fever VS Vital sign modifiers
2 VS 1 Shock
2 Petechial rash 1 Unconscious (GCS 3-9)
4 Fever 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
mod
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 853 Hyperglycemia

Hyper pe
1
glyce VS Vital sign modifiers
mia
>18 mmol/L symptomatic, 1 Shock
2 Dyspnea, dehydration, 1 Unconscious (GCS 3-9)
weakness 2 Moderate respiratory distress
>18 mmol/L not 2 Altered level of consciousness (GCS 10 - 13)
symptomatic 2 <3 mos, T < 36C OR >38C
mod
Critic
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 854 Hypoglycemia

Hypo pe
1
glyce VS Vital sign modifiers
mia
<3 mmol/L symptomatic, 1 Shock
Confusion, diaphoresis, 1 Unconscious (GCS 3-9)
2
behavioral change, 2 Moderate respiratory distress
seizure, infant < 1 yr 2 Altered level of consciousness (GCS 10 - 13)
2 <3 mos, T < 36C OR >38C
<3 mmol/L not
symptomatic 3 Mild respiratory distress
mod
Critic
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 855 Direct referral for consultation

Direct
referr
pe
1
al for
cons
ultati 1 Severe respiratory distress
2on VS, PS 1 Shock
3 VS, PS, Chronicity 2 Moderate respiratory distress
Direct referral for
5 2 <3 mos, T < 36C OR >38C
consultation 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
Ped
look

dyn
Resp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 856 Dressing change

Dress
pe
3
ing
chan
ge 3 Mild respiratory distress
5 Dressing change 3
3
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 859 Imaging tests

Imagi
5
ng Imaging test
tests
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 860 Medical device problem

Medic
al
1
devic
e
VS pe
probl
2
em VS, PS 1 Severe respiratory distress
1 Shock
Medical device problem; 2 Hemodynamic compromise
4 'asymptomatic' or 'no 2 Fever, immunocompromised
distress' 2 <3 mos, T < 36C OR >38C
4 PS 3 Mild respiratory distress
mod
Critic
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 861 Prescription / Medication request

Presc
riptio
n/
Medic Prescription / medication
5
ation
reque request
st
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 862 Ring removal

Ring pe
2
remo VS, PS Vital sign modifiers
val
Neuro-vascular
compromise 4 >36 mos, T >38.5 C & appearing well (non-toxic)
3 VS, PS 2 Acute severe pain (8-10)
4 VS, Ring removal 4 Acute mild pain ( < 4 )
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 863 Abnormal lab values

Abno
rmal pe
2
lab VS, BD Vital sign modifiers
value
3s
VS, BD 1 Shock
3 Normal VS, critical value 2 Moderate respiratory distress
Normal VS, non critical 2 Fever, immunocompromised
5 2 <3 mos, T < 36C OR >38C
value 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
look
CNS
Hemo
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 865 Post-operative complications

Post-
opera
pe
2
tive
comp
VS, PS, BD Vital sign modifiers
licati 2 Moderate respiratory distress
3
ons VS, PS, BD 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
Normal VS, no pain,
routine check 3 Mild respiratory distress
Ped
look

dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 864 Pallor / Anemia

Pallor
pe
1 /
Anem
ia
2 VS, BD 1 Shock
4 Pallor / Anemia 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
mod
dyn
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 603 Inconsolable crying in infants

Incon
solab
le pe
1
cryin VS Vital sign modifiers
g in
2
infant
s
VS 1 Shock
Inconsolable infant -
abnormal vital signs 2 Hemodynamic compromise
2 <3 mos, T < 36C OR >38C
Inconsolable infant - vital 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
3
signs stable 3 Mild respiratory distress
Ped
4 Irritable but consolable 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) mod
look
4 VS 4 >36 mos, T >38.5 C & appearing well (non-toxic)
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 611 Congenital problem in children

Cong
enital
pe
1
probl VS Vital sign modifiers
em in
childr
2
en VS, BD 1 Severe respiratory distress
1 Shock
Conditions and protocol 1 Unconscious (GCS 3-9)
letters identifying concerns for
rapid deterioration or need for 2 Altered level of consciousness (GCS 10 - 13)
immediate therapy 2 Fever, immunocompromised
2 <3 mos, T < 36C OR >38C
Vomiting/diarrhea in a child 2 3-36 mos, T <32C OR >38.5C, & appearing unwell (toxic)
with inherited metabolic 3 Mild respiratory distress
2
disease, type 1 diabetes or 3 Vital signs outside the limits of normal
Ped
adrenal insufficiency 3 >36 mos, T >38.5C, & appearing unwell (toxic)
mod
Critic
look
3 VS, BD CNS
Caregivers identifying need 2 Bleeding disorder (life or limb threatening bleed) Hemo
3 3 Bleeding disorder (moderate or minor bleeds)
dyn
for care Resp
VS, Stable child with Temp
4 congenital disease with Pain

potential for problems BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 866 Minor complaints NOS

Minor
pe
2
comp
laints
NOS
3 VS, PS, Chronicity 2 Hemodynamic compromise
Minor complaints, 2 <3 mos, T < 36C OR >38C
unspecified 3 Mild respiratory distress
Critic
CNS
Hemo
4 Acute mild pain ( < 4 ) dyn
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
Qc Code 480 Diarrhea & Fever (Qc)

Diarr
pe
1
hea &
Fever
(Qc)
VS, moderate 1 Severe respiratory distress
2 1 Shock
dehydration 1 Unconscious (GCS 3-9)
Uncontrolled bloody 2 Moderate respiratory distress
diarrhea 2 Altered level of consciousness (GCS 10 - 13)
3 VS, Mild dehydration
2 <3 mos, T < 36C OR >38C
3 Mild respiratory distress Ped
mod
Critic
3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic) look
Note: In Quebec the MSSS has CNS
4 >36 mos, T >38.5 C & appearing well (non-toxic) Hemo
designated dyn
“Diarrhea and fever” as a Resp
separate complaint from Temp
Diarrhea or Fever Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
Qc Code 600 Depression (Qc)

Depre
ssion
2
(Qc)
risk Suicide Self injurious behavior with a non fatal
depressed, no suicidal or implicit) that the person attempted to die.
4
ideation Suicide intent Subjective expectation and desire for self-
Note: In Quebec the MSSS Suicidal Thought of serving as an agent of one’s

has “Depression / Suicidal / depending on specificity of plans and
Deliberate self harm”
Uncertain Patients threatening violence towards
separated in 3 different flight or themselves or others; patients exhibiting
Ped
mod
complaints safety risk uncontrolled anger, restlessness, paranoia,

or hallucinatory behavior; or patients unable
Critic
look
or unwilling to cooperate with suicide risk CNS

assessment and who pose a flight risk. Hemo
Need close observation based on site dyn
resources. Resp
Temp
observation may not be required.) Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
Qc Code 680 Suicidal ideations (Qc)

Suici
dal
2
ideati clear suicide plan Suicidal Term Definition
ons
2
(Qc)
active suicidal intent Suicide Self injurious behavior with a non fatal
or implicit) that the person attempted to die.
2 Suicide intent Subjective expectation and desire for self-
risk destructive act that would end in death.
3 suicidal ideation, no plan Suicidal Thought of serving as an agent of one’s
Note: In Quebec the MSSS degree of suicidal intent.
has “Depression / Suicidal / Uncertain Patients threatening violence towards Ped

flight or themselves or others; patients exhibiting mod
Deliberate self harm” safety risk uncontrolled anger, restlessness, paranoia, Critic
look
or hallucinatory behavior; or patients unable
separated in 3 different or unwilling to cooperate with suicide risk CNS
complaints assessment and who pose a flight risk. Hemo

dyn
resources. Resp
Temp
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
Qc Code 681 Suicide attempt (Qc)

Suici
de
2 attempted suicide
attem
pt
Suicide Self injurious behavior with a non fatal
(Qc)
2 attempt outcome accompanied by evidence (explicit
risk or implicit) that the person attempted to die.

Note: In Quebec the MSSS has
“Depression / Suicidal / ideation own death, may vary in seriousness
Deliberate self harm” depending on specificity of plans and
separated in 3 different
Uncertain Patients threatening violence towards
complaints flight or themselves or others; patients exhibiting
Ped
mod
uncontrolled anger, restlessness, paranoia, Critic
look
or unwilling to cooperate with suicide risk CNS

assessment and who pose a flight risk. Hemo
Need close observation based on site dyn
resources. Resp
Temp
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
Qc Code 1180 Cough and Fever (Qc)

Coug
pe
2
h and
Fever
(Qc)
2 <3 mos, T < 36C OR >38C
Note: In Quebec the MSSS has 3 Mild respiratory distress
designated 3 3-36 mos, T 32-35C OR >38.5C & appearing well (non-toxic)
“Cough and fever” as a 3 >36 mos, T >38.5C, & appearing unwell (toxic)
separate complaint from Ped
mod
Cough or Fever Critic

look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
Peds: Dehydration
PedIATRIC COT
Peds:
dehydration
CTAS
Level Peds: Level of Dehydration
Severe dehydration: marked volume loss with classic signs of

1 dehydration and signs and symptoms of shock
Moderate dehydration: dry mucous membranes, tachycardia, plus

2 or minus decreased skin turgor and decreased urine output.
Mild dehydration: stable vital signs with complaints of increasing Ped

3 thirst and concentrated urine & a history of decreased fluid intake or mod
Critic
increased fluid loss or both. look
CNS
Hemo
Potential dehydration: no symptoms of dehydration but presenting dyn
4 cause of fluid loss ongoing or difficulty tolerating oral fluids. Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Complaint Oriented Triage 2008
2012 – Canadian Triage and Acuity Score 2008
2012 405
Go to Pediatric COT
ment
Skin
Go to Adult COT
Go to Pediatric COT Neuro Ophth Nose Ears Resp G. I. Ortho Trauma Skin
abuse Health other Vasc GYN Urin ment ral
PedIATRIC COT
Definitions

Go to Adult COT Neuro Ophth Nose Ears Resp G. I. Ortho Trauma Skin
buse Health other Vasc GYN Urin ment ral
PedS Abbreviations: ADULT

COT
Ped
mod
COT: Complaint oriented triage COT
VS: Vital signs
Mod
Critic Adult
look
CNS
PS: Pain Scale

CNS
Hemo
Hemo dyn
dyn
PSP: Pain Scale, Peripheral

Resp
Resp
Ped
Temp mod
Temp
PSC: Pain Scale, Central

Critic
Pain look
Pain
Bleed CNS
Bleed
MOI
BD: Bleeding disorder MOI
Hemo
dyn
MOI: Mechanism of injury

Resp
Temp
Chronicity: Chronicity component Pain
BD
MOI
Last slide Last slide
viewed Def.
viewed
2012 406
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
Lund-Browder chart (for children) and Rule of nines (for adults)
for estimating extent of burns.
BSA
Ped
mod
Critic
look
Anterior Posterior CNS
Hemo
<1 yr 1 yr 5 yr 10 yr 15yr dyn
A: ½ of head 9.5% 8.5% 6.5% 5.5% 4.5% Resp
B: ½ of a thigh 2.75% 3.25% 4.0% 4.25% 4.5% Temp
C: ½ of a lower leg 2.5% 2.5% 2.75% 3.0% 3.25%
Pain
BD
MOI
viewed Def.
viewed
2012 407
Go to Pediatric COT
ment
Skin
Go to Adult COT
Go to Pediatric COT Neuro Ophth Nose Ears Resp G. I. Ortho Trauma Skin
abuse Health other Vasc GYN Urin ment ral
PedIATRIC COT
Definitions
Glascow

Go to Adult COT Neuro Ophth Nose Ears Resp G. I. Ortho Trauma Skin
buse Health other Vasc GYN Urin ment ral
PedS Pediatric-GCS for children < 2 years old Glascow Coma Scale
Eye Opening Eye Opening
ADULT
COT Spontaneously 4 Spontaneously 4
In response to voice 3 In response to voice 3
Ped
mod
In response to painful stimuli 2 In response to painful stimuli 2 COT
Does not open eyes 1 Does not open eyes 1 Mod
Critic Adult
look
Verbal response Verbal response CNS
CNS
Coos, babbles 5 Oriented 5 Hemo
Hemo Irritable cry 4 Confused 4 dyn
dyn Cries to pain 3 Utters inappropriate words 3
Resp
Resp Moans to pain 2 Incomprehensible sounds 2
None 1 Makes no sounds 1 Ped
Temp mod
Temp
Critic
Motor response Motor response Pain look
Pain Normal spontaneous movement 6 Obeys commands 6
Withdraws to touch 5 Localizes painful stimuli 5 Bleed CNS
Bleed Withdrawal to painful stimuli 4 Withdrawal to painful stimuli 4 Hemo
Abnormal flexion to painful stimuli 3 Abnormal flexion to painful stimuli 3 MOI dyn
MOI
Extension to painful stimuli 2 Extension to painful stimuli 2 Resp
None 1 None 1
Temp
http://www.guideline.gov/summary/summary.aspx?doc_id=12319
http://www.co.marin.ca.us/depts/hh/main/ems/documents/policies/8310pedtxr.pdf Pain
http://fr.wikipedia.org/wiki/%C3%89chelle_de_Glasgow
http://www.urgencyclopedie.info/index.php/Score_de_Glasgow
BD
MOI
viewed Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
system
Coding
NACRS Code 869 Newly Born

pe
1
Newly
VS
Born Vital sign modifiers
1 Shock
2 Newly Born 1 Unconscious (GCS 3-9)
Ped
mod
Critic
look
CNS
Hemo
dyn
Resp
Temp
Pain
BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
CTAS Respiratory Rate Guidelines
Age Lev 1 Level 2 Level 3 Level 4 & 5 Level 3 Level 2 Lev 1
0 < 17 < - 26 < - 35 - 53 - > 62 - > 71 >
3 mon < 16 < - 25 < - 33 - 51 - > 60 - > 68 >
6 mon < 15 < - 23 < - 32 - 48 - > 57 - > 65 >
9 mon < 14 < - 22 < - 30 - 46 - > 54 - > 62 >
12 mon < 14 < - 22 < - 29 - 44 - > 52 - > 59 >
15 mon < 14 < - 21 < - 28 - 42 - > 49 - > 56 >
18 mon < 14 < - 20 < - 27 - 39 - > 46 - > 52 >
21 mon < 14 < - 20 < - 26 - 37 - > 43 - > 49 >
24 mon < 14 < - 19 < - 25 - 35 - > 40 - > 45 >
3 yr < 14 < - 18 < - 22 - 30 - > 34 - > 38 >
4 < 15 < - 18 < - 21 - 24 - > 30 - > 33 >
5 < 15 < - 18 < - 20 - 23 - > 28 - > 31 >
6 < 15 < - 17 < - 19 - 22 - > 27 - > 29 >
7 < 14 < - 16 < - 19 - 21 - > 26 - > 28 >
Ped
8 < 13 < - 16 < - 18 - 20 - > 25 - > 27 > mod
9 < 13 < - 15 < - 17 - 20 - > 24 - > 27 > Critic
look
10 < 12 < - 15 < - 17 - 19 - > 24 - > 26 >
11 < 12 < - 14 < - 16 - 19 - > 24 - > 26 > CNS
12 < 11 < - 14 < - 16 - 18 - > 23 - > 26 > Hemo
dyn
13 < 11 < - 13 < - 16 - 18 - > 23 - > 25 >
14 < 10 < - 13 < - 15 - 17 - > 22 - > 25 > Resp
15 < 10 < - 12 < - 15 - 17 - > 22 - > 24 > Temp

16 < 9 < - 12 < - 14 - 16 - > 21 - > 24 >
17 < 9 < - 11 < - 13 - 16 - > 21 - > 23 > Pain
18 < 9 < - 11 < - 13 - 15 - > 20 - > 22 > BD
MOI
Last slide
Def.
viewed
Go to Pediatric COT
ment
Skin
Go to Adult COT
PedIATRIC COT
CTAS Heart Rate Guidelines
Age Lev 1 Level 2 Level 3 Level 4 & 5 Level 3 Level 2 Lev 1
0 < 79 < - 95 < - 111 - 143 - > 159 - > 175 >
3 mon < 95 < - 111 < - 127 - 158 - > 173 - > 189 >
6 mon < 91 < - 106 < - 121 - 152 - > 167 - > 183 >
9 mon < 86 < - 101 < - 116 - 145 - > 160 - > 175 >
12 mon < 83 < - 97 < - 111 - 140 - > 155 - > 169 >
15 mon < 79 < - 94 < - 108 - 137 - > 152 - > 166 >
18 mon < 76 < - 90 < - 105 - 134 - > 148 - > 163 >
21 mon < 73 < - 87 < - 102 - 131 - > 145 - > 159 >
24 mon < 71 < - 85 < - 99 - 128 - > 142 - > 156 >
3 yr < 64 < - 78 < - 92 - 120 - > 135 - > 149 >
4 < 59 < - 73 < - 88 - 116 - > 130 - > 144 >
5 < 56 < - 70 < - 84 - 112 - > 126 - > 140 >
6 < 53 < - 67 < - 81 - 109 - > 123 - > 136 >
7 < 50 < - 64 < - 78 - 105 - > 119 - > 133 >
8 < 47 < - 61 < - 75 - 102 - > 116 - > 129 > Ped
mod
9 < 45 < - 59 < - 72 - 99 - > 113 - > 126 > Critic
look
10 < 43 < - 57 < - 70 - 97 - > 110 - > 124 >
11 < 42 < - 55 < - 68 - 95 - > 108 - > 122 > CNS
12 < 40 < - 53 < - 67 - 93 - > 106 - > 120 > Hemo

dyn
13 < 39 < - 52 < - 65 - 92 - > 105 - > 118 >
Resp
14 < 37 < - 51 < - 64 - 90 - > 103 - > 116 >
15 < 36 < - 49 < - 62 - 89 - > 102 - > 115 > Temp
16 < 35 < - 48 < - 61 - 87 - > 100 - > 113 >
Pain
17 < 34 < - 47 < - 60 - 86 - > 99 - > 112 >
18 < 33 < - 45 < - 58 - 85 - > 97 - > 110 > BD
MOI
Last slide
Def.
viewed

Cot 2012 English Canada v02.02 1 0

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Cot 2012 English Canada v02.02 1 0

Uploaded by

Copyright:

Available Formats

Complaint Oriented Triage 2012 – Canadian Triage and Acuity Score 2012

COT 2012 - (English Canada Version 02.02)

© Canadian Association of Emergency Physicians

Bernard Unger Michael Bullard

Original COT Contributors

Hemodynamic Status Mechanism of Injury

Severe: Fatigue from excessive work of

Moderate: Increased work of breathing,

3 breathing, able to speak in sentences, stridor 94%

without any obvious airway obstruction. BD

Shock: evidence of severe end-organ hypoperfusion: marked pallor,

Hemodynamic compromise: evidence of borderline perfusion;

2 hypotension (by history), feeling faint on sitting and standing, or

Unconscious: unable to protect airway, response 3–9

Altered level of consciousness: response 10 – 13

Adults: Temperature / Sepsis

comfortable and in no distress. MOI

Life or Limb Threatening Moderate/Minor

CTAS level 2 CTAS level 3

Head (intracranial) & neck Nose (epistaxis)

Chest,abdomen,pelvis,spine Mouth (including gums)

Massive vaginal hemorrhage Joints (hemarthroses)

Iliopsoas muscle & hip Menorrhagia

Deep lacerations Temp

Hallucination / Definition Bizarre Definition

Paranoia Delusions of a persecutory nature - being Controlled Bizarre, irrational behavior

Substance withdrawal Hemo

Mental health and psychosocial issues

Hallucinations / Delusions Bizarre behaviour

Insomnia Concern for patient's welfare

Violent / Homicidal behaviour Pediatric Disruptive behaviour

Deliberate self harm Hemo

Confusion Head injury

Headache Sensory loss / Parasthesias Adult

Foreign body, eye Diplopia

Visual disturbance Periorbital swelling

Eye pain Eye trauma Mod

Nasal congestion / Hay fever

Foreign body, nose

URTI complaints Mod

Foreign body ear

ENT – Mouth, Throat, Neck

Neck swelling / pain Mod

Respiratory arrest Allergic reaction

Hemoptysis Apneic spells in infants Mod

Cough / Congestion Wheezing – no other

Cardiac arrest (traumatic) Syncope / Pre-syncope

Chest pain (cardiac features) Edema, generalized

Hypertension Unilateral reddened hot limb Temp

Anorexia Blood in stool / Melena

Foreign body in rectum Hiccoughs

Groin pain / mass Abdominal mass / distention Mod

Diarrhea Feeding difficulties in newborn Pain

Neonatal jaundice MOI

Foreign body, vagina Labial swelling

Vaginal discharge Pregnancy issues < 20 wks

Vaginal pain / itch Pregnancy issues > 20 wks Mod

Hematuria UTI complaints

Genital discharge / lesion Oliguria

Penile swelling Polyuria Mod

Traumatic back / spine injury Lower extremity injury

Amputation Joint(s) swelling

Upper extremity pain Cast check Mod