From the Research
CTAS level 4 and 5 conditions in Canadian and US emergency departments represent non-urgent and less acute presentations that could often be managed in primary care settings, including minor trauma, uncomplicated infections, and chronic conditions, as seen in studies such as 1. These conditions can be categorized into two main levels:
- CTAS level 4 conditions, which include:
- Minor trauma like simple lacerations requiring sutures
- Stable fractures
- Sprains and strains
- Mild to moderate pain (4-7/10)
- Uncomplicated urinary tract infections
- Mild dehydration
- Minor infections like cellulitis without systemic symptoms
- CTAS level 5 conditions, which are truly non-urgent and include:
- Medication refills
- Minor rashes
- Mild upper respiratory infections
- Chronic stable pain
- Minor wounds not requiring closure
- Routine dressing changes
- Removal of sutures or staples According to a study published in 2019 1, the most frequent diagnoses observed in CTAS level 4 and 5 conditions include:
- Acute pharyngitis
- Conjunctivitis
- Rash and other nonspecific skin eruption
- Otitis externa
- Cough
- Acute sinusitis
- Dermatitis These patients typically have normal vital signs, can wait several hours without deterioration, and often present with conditions that developed days to weeks earlier, as noted in studies such as 2 and 3. Emergency departments use these triage categories to prioritize more urgent cases, though many CTAS 4-5 patients seek emergency care due to limited access to primary care, after-hours medical needs, or perceived urgency of their symptoms, highlighting the need for alternative care models, such as those involving pharmacists with expanded scope of practice, as discussed in 1. While these conditions are considered lower acuity, they still require appropriate medical assessment and treatment, even if they don't need immediate intervention, and can potentially be managed by pharmacists with expanded scope of practice, as seen in 1.