Can someone explain how triage in emergency works?

[glenny_c]

I don't envy anyone working in an ED. If we need to go to the ED, we go to a private one now. You don't need PI, but you pay $150 and get seen straight away. Depending on the complaint you can end up getting most back from Medicare. I don't do this because I think they are any better than workers in public hospitals, but I think the public hospitals are so understaffed and overworked. I don't know how ED nurses cope with the constant complaints, I think they are amazing!

[Astrid]

Ok, so going by this, I should have been seen in 1/2 an hour, it took 4. I had people with stabilised fractures, who arrived after me and went through before me (they had xrays whilst waiting, so that is something sensible they do). I could go on, but I presented to the emergency department enough times with the girls, to know that something was seriously wrong with the system yesterday.

Thanks for the info.

[Ahurani]

Well with the bed closures ED's are under the pump even more so than usual. It's probably normal to be seen in that time anyway unfortunately.

[Astrid]

Rural hospital with no bed closures that day. Relatively small ED compared to places like Melbourne.

[Tegam]

Oh and to add- there are the smarties who know the system well and claim to have attempted suicide just so the are seen to mire quickly.


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Or the ones that go home and call an ambulance to be seen quicker!

[Freya]

I think the problem with triage lies not in the hospital's system but in who is going to the ER to be triaged in the first place!

Everytime I have been to the ER (usually with a very ill kid or a child with suspected concussion/head injur) I just sit and stare in wonder at who comes in with maladies that could be taken care of TOMORROW at a GP or by a quick trip to the chemist, while my 2yo with a mangled mouth and blood spurting everywhere gets chucked in the waiting room for 3hrs. Seriously (a teenage girl got through before us for...............conjunctivitis!) And the hospital cannot turn them away so they have to be added to the queue. Even more of a pain in the behind is when you know there is an after hours GP right there but they still insist on being in the ER.

I think whats most dangerous is, its got to the point now where I really hesitate at heading to the ER even when my instincts say its neccesary. Because I dont want to wait for hours and hours. Im sure Im not the only person who would think that and it could be the difference between life and death. I really feel for the ER staff.

[skybie]

When i was diagnosed with diabetes i was sent to emergency by my GP, i walked in talking, laughing ect, i was seen to immediately and had drips put in ect withn 5 mins of being there. i was DKA and the emergency dr was very suprised i was still concious given my ketone levels.
So just because someone doesnt seem 'sick' doesnt mean they arent hours away from life support! i was very very lucky

[Ahurani]

Just because your brought in by an ambulance doesn't mean you will be seen quicker. Your still triaged and will be sat in the waiting room if need be

[Astrid]

Very true Freya. Some of them yesterday I did wonder why they had not gone to a GP, I did consider mine first, but realised I could not wait. The only good thing I could see was that they were treating children quickly, which was a nice change.

I will be making an appointment with my GP with regards to yesterday and will find out what to do if it happens again. The problem I find though, is the Doctors say one thing, but then reception does not comply, so I could call up/walk in as advised, but they could turn me away.

[~TT40~]

Those staff that work in emergency dont sit on their arses all day cause its fun to make you wait. They are run off their feet and see people as soon as physically possible.
Prioritsing and timeframes are easy in theroy but in practice it is so much different, so many different factors in play, staff mix, skill mix, beds avaliablility (not just in the emergency department but the whole hospital - 'bed block' means there are literly no empty beds in the hospital and with people still coming through the emergency have to hold those that would normally go to a ward thus taking up emergency beds) and yes a big part of it is why people present.
Im not saying peoples reasons here werent valid but im a just a little sensitive to ppl slagging off the department. I use to work in one of the busiest in sydney every single shift drained you physically mentally and emotionally. im sure those working there were doing the best they could.
/rant

sent via my vortex manipulator

[Astrid]

I am not slagging it off. I truely wanted an understanding of how things work, which is why I asked the question. Trying not to be ignorant.

If anything it has helped me realise that the way I was treated yesterday was not appropriate, not just to do with length of wait, but other things. Once I was being treated, I could not fault the Dr and the nursing staff, if is the way triage was being done yesterday that I had real concerns with.

[Bumperstump Cummerbund]

I don't think anyone is slagging off ED staff, I know they work very hard. It can get very frustrating though, sitting in a waiting room in agony while people that appear less serious than yourself are seen first. The system doesn't always work.

I once went to an ED, doubled over in agony and sobbing from the pain. The triage nurse said it might be a while coz a car accident had just come in, so she gave me 2 PFs because I was clearly in pain. 2 hours later when I was called in, the doctor ripped me a new one for 'wasting valuable resources when I clearly wasn't in pain'. That ended up being my second miscarriage.

I think that having the right staff makes a difference too - not everyone who is a qualified nurse/doctor is capable of working well in an ED. I know that what's ideal isnt always possible though.

[Traveller]

I think my local emergency department must be one of the best around, going by some of the comments here. Every time I have been (with a variety of complaints, from a kid with a fever and tachycardia, to a child who swallowed a glass pebble and just needed an x-ray to check there was no blockage) we have been seen within an hour. My husband was given the same treatment when he had whiplash, so it wasn't just that it was my kids needing treatment. The staff are amazing and always apologise about the wait. My only complaint is that the fast track waiting room has no kids toys, but if you ask they will let you wait in the kids waiting room instead even though you are being fast tracked. Any time my child had a serious complaint we were given a bed straight away. Maybe I have just always gone at quiet times but I have never seen long queues for treatment.

[Cranky Kitten]

I think a large part of the going to ED when could reasonably see a GP stems from the lack of bulk billing GPs - those who don't have the spare $50-70 (or more for after hrs) to pay for a visit to the doc have little choice. And they have to be seen eventually, even if they do end up waiting a while - so may be slipped through in a short gap between more serious/complex issues. I do know there have been times where it's been suggested I may be better off seeing a GP (even for a suspected broken ankle) but they can't refuse treatment.

[Traveller]

maybe that's the difference with my ED then. There are at least 2 large bulk bill clinics directly across the road from it that are open 7am to midnight so a lot of people from triage are directed to them. And vice versa, I have been to the bulk bill clinic to be told that in fact I should go to ED.

[emc2]

Some things I have been to emergency for, it may have appeared that I had been seen but it has sometimes to be referred to another waiting area.

[lilima]

Just to add, my DH is a paramedic, and people think if you call the ambo's you get triaged quicker. Not true. In fact if they are brought in on a stretcher, DH has to stay with them until the are triaged. This then means that the area that DH is covering is down an ambo.

Oh- and some of the things he gets called out to are laughable.

It is a shame that genuine people end up waiting while there is a backlog of people with minor illnesses.

I to commend the triage teams. They do an awesome job. Both times I have taken DD in, they have been great. Both times, she appeared happy like nothing was wrong, and both times she was subsequently admitted in to hospital. So yes - appearances can be deceiving .

I too thiNk that if there was the introduction of more of the 'superclinics' then there may be a reduction in the number of people with minor ailments presenting through the ED.

[Butterfly Dawn]

In alot of asian countries you dont have GPs so every time you are sick you go to the hospital. When people immigrate this isnt explained to them, so when they are sick they go to the hospital ED and clogg up the system- simply because they dont know. Perhaps there could be little packs made by some Government dep to give to homestay familys/ english schools/ community centres that can explain the way things work in AU/NZ.- Just a random thought as Im getting ready to take DS2 back to hospital for outpatient IV for his cough.