Best Practices

What are High and Low Acuity Patients?

Meg Marino, MD, FAAP

October 20, 2022

We often hear the term “acuity” when referencing patient condition but understanding what acuity measures, identifies, and provides for first responders can help better frame how we treat and respond to patients’ specific needs. 

What is Patient Acuity? 

Patient acuity is a measurement of the level of care a patient need based on the severity of either an illness or mental condition. Patient acuity can also determine the staffing level required to treat patients when used in the hospital setting. The care is typically divided into high, commonly referred to as critical or emergent, and low levels, which are signified through self-reported or measured health status markers. For those in the prehospital space, patient acuity is used to determine the level of response needed by emergency services and mode of transportation. 

How is Patient Acuity Identified? 

In the prehospital setting, acuity can often be determined by patient complaints at the dispatch level. As dispatchers receive and route calls, they can typically identify a patient’s acuity level through their complaints, primary symptoms, or comorbidities. For example, if a patient calls 9-1-1 with complications around congestive heart failure, that registers as an immediate marker of a high acuity patient. Conversely, if a patient calls in with feelings of congestion or a stuffy nose, those would be markers of a low acuity patient. Dispatchers must work to gather sufficient detail and information to classify a patient’s symptoms and presentation best to help uncover the correct classification. By understanding a patient’s acuity level, dispatchers can best help patients receive the appropriate level of care for their needs. 

High versus Low Acuity Patients

According to the National Highway Traffic and Safety Administration, the two levels of patient acuity can be described:

  • Critical (High): Patient presents with symptoms of a life-threatening illness or injury with a high probability of mortality if immediate intervention is not begun to prevent further airway, respiratory, hemodynamic, and/or neurologic instability, 
  • Emergent (High): The patient presents with symptoms of an illness or injury that may progress in severity or result in complications with a high probability of morbidity if treatment is not begun quickly. 
  • Lower Acuity: The patient presents with symptoms of an illness or injury that have a low probability of progression to a more serious disease or development of complications. 

Facilitating Patient Care by Acuity Level 

Once the patient’s acuity level has been identified, dispatchers can resource and route the right level of care to the patient’s need. For each acuity level, EMS agencies should establish common tasks for scene management, the use of assessment tools, therapeutic interventions, communication paths and escalation, and documentation. 

Often EMS agencies code high acuity patients with particularly emergent needs to have specific protocols, practices, and responder teams, such as those patients with stroke or respiratory arrest. In addition, high acuity patients typically need transport, often with lights and sirens, and advanced life support (ALS) care. For these patients, having low acuity patients usually require only basic life support (BLS) services or no transport. Low acuity patients can often benefit from alternative healthcare programs such as telemedicine or treatment in place protocols that allow patients to be treated by community paramedicine programs or through remote physician visits. In doing so, resources can be better allocated to those presenting as high acuity without reducing care responses for low acuity patients. 

MD Ally provides dispatch-integrated telemedicine specifically designed to take on the needs of low acuity patients. As patient acuity is identified those, who are categorized as low acuity are connected with telemedicine services which can help patients receive the care they need without the use of EMS services and resources. Click here to learn more about how MD Ally can help your agency facilitate the care of low acuity patients.