The Emergency Severity Index (ESI) is a five-level emergency department triage algorithm that provides a clinical stratification of patients: 1 most urgent to 5 least urgent. This system is designed to enhance patient safety and flow. ESI triage is based on patient's acuity. Testicular torsion, an ESI 2 is an example of a time-sensitive clinical situation capable of producing risk to life, limb, or organ.