What is an ED
The Emergency Department is the hospital department which provides immediate treatment. No other specialty in medicine sees the variety of conditions that an emergency room doctor sees1.
Triage
When you arrive at the Emergency Department1, your first stop is triage. This is the place where each patient’s condition is evaluated and prioritised, usually by a nurse, into five general categories, symbolised by colours. The categories are:
- immediately life threatening (RED-1)
- urgent, but not immediately life threatening (ORANGE-2)
- urgent but deferrable (BLUE-3)
- less urgent (GREEN-4)
- not urgent and not needing to be assisted at the Emergency Department (WHITE-5).
Registration
The triage nurses record your vital signs (temperature, pulse, respiratory rate and blood pressure). They also get a brief history of your current medical complaints, past medical problems, medications and allergies so that they can determine the appropriate triage category.
After triage, the next step is registration. This step is necessary to create a medical record that can be used at any time.
The examination room
Patients are then brought to the examination room. Some emergency departments have separate areas, which can include a paediatric ED, a chest-pain ED, a fast track (for not serious injuries and illnesses), a trauma centre (usually for severely injured patients) and an observation unit (for patients who do not require hospital admission but require prolonged treatment or many diagnostic tests).
Emergency medicine doctors
Once the nurses have finished their tasks, it is the turn of the emergency medicine doctors. They get a more detailed medical history about present illness, past medical problems, family history, social history, and a complete review of all body systems.
Then, they formulate a list of possible causes of your symptoms. This list is called a differential diagnosis. The diagnosis is then compared to the patient’s symptoms and physical examination. If this is inadequate to determine the final diagnosis, then diagnostic tests are required.
When an operation is necessary
At this point, the emergency medicine doctor may speak to a general surgeon.
The surgeon performs a complete history, physical exams and reviews the results of the diagnostic tests, examines the symptoms once more and may decide that an operation is necessary.
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1 Emergency medicine is a specialty. Special training is given to medical students to learn how to work in the ED.
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1 The ED is for emergencies. When shouldn’t you go there?
