What to expect in the emergency department

“The emergency department is an area in the hospital where we can quickly assess patients, make them better, or decide they’re going to need additional testing or management and admit them to the hospital,” says Jeffrey Oyler, M.D., an emergency medicine physician at Piedmont Atlanta Hospital.

Triage

Every patient who visits the emergency department (ED) will go through triage, which allows the ED team to establish the severity of that person’s condition. Triage takes into account the patient’s vital signs, as well as his or her complaint.

Dr. Oyler says measuring the patient’s vital signs is the most crucial component of triage because these signs are essential to assessing the patient and are something that cannot be faked.

The patient is then categorized based on the Emergency Severity Index:

• Level 1 – Immediate: life-threatening
• Level 2 – Emergency: could be life-threatening
• Level 3 – Urgent: not life-threatening
• Level 4 – Semi-urgent: not life-threatening
• Level 5 – Non-urgent: needs treatment as time permits

“It’s hugely important for us to establish who is the sickest, so we can provide the interventional care they need immediately, then work our way down the list as fast as we can,” says Dr. Oyler.

Based on the assessment by the triage nurse, the patient will either be:

• Taken to an exam room. If all rooms are full, that person will be next in line for a room. Dr. Oyler emphasizes that patients are not seen in the order of arrival, but based on the severity of their condition.
• Offered a fast-track service. The fast track does not have all of the capabilities of the emergency department, but is intended to help patients with minor emergencies get through the system. People in the waiting room may see other patients with minor injuries being called back before those with more serious injuries, but they are actually being treated in the fast-track area, Dr. Oyler explains.

Behind the waiting room doors

“A quiet waiting room is something we ideally love to have, but it is not a reflection of what is going on in the back,” says Dr. Oyler. “You can have one person or 20 people in your waiting room, but you could have complete chaos in the back with very, very sick patients.”

Although the ED waiting room may not seem busy, the behind-the-scenes ambulance bay can bring in patients at all hours of the day.

“You can have an incredibly long wait in our emergency department if you show up with a non-life-threatening condition that could have waited for treatment at your primary care physician’s office the next day,” he says.

“We are sensitive to the fact that you are waiting,” says Dr. Oyler. “We want you to get back to a room and be seen as fast as possible, but we’re also prioritizing care for people who absolutely have to have it right then and there.”

Dr. Oyler stresses the importance of patience if your illness or injury is not life-threatening.

“We know you’re suffering and it’s not what we desire, but when your time comes, you’re going to get the service you wanted.”

If your condition is not an emergency, you can save time and money by visiting an urgent care center or your primary care physician’s office. Insurance co-pays are usually more expensive at the emergency department compared to co-pays at other facilities.

For more information on emergency services at Piedmont’s five campuses, visit:

• Piedmont Atlanta Hospital
• Piedmont Fayette Hospital
• Piedmont Henry Hospital
• Piedmont Mountainside Hospital
• Piedmont Newnan Hospital