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First Come, First Served?

December 30, 2010

Emergency department overcrowding can result in long waiting times for seriously ill patients. They then compete with patients with less severe illnesses for the next available treatment. In this edition of Deutsches Órzteblatt International (Dtsch Arztebl Int 2010; 107[50]: 892ð”Æ’“ ), Michael Christ and his coauthors provide an overview of current practice for initial assessment of emergency patients.

Triage provides reliable methods that can be used to assess the severity of an illness and the urgency of treatment in emergency departments.

In English-speaking countries, five-level triage systems are already being successfully applied. For example, trained nursing staff uses them to ascertain whether basic life support is needed, whether patients are in severe pain, or whether further diagnostic procedures are needed. Triage can significantly improve the mostly subjective assessment methods used in Germany. In Australia it is already improving patient safety, reducing their waiting times, and increasing the professional satisfaction of emergency department staff.

The authors’ own experience shows that trained, specialized staff can use a German translation of the Emergency Severity Index to assess emergency patients in Germany reliably, too.

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