Waiting to die: the hidden pandemic of ED crowding and excess mortality

CJEM Debate Series: #TriageAgain—are current triage methods dangerous?… if we cannot actually treat those triaged as urgent within a safe time frame?

“…In our post-pandemic emergency care crisis, we face staffing pressures, crowding, burnout, long wait times, and many other pressures in our emergency departments (EDs) [2]. Perhaps the emergency care system's most shocking failures have been the reported mortality increases directly associated with long ED stays-usually because of access-block [3]. Under these circumstances, it would seem logical that a sorting, prioritization, or triage system would be vital and a major focus, yet currently triage targets are not being met in the majority of hospitals, the majority of the time.…”

“…Prolonged waiting and crowding increase mortality [3] and it is incumbent on us in emergency medicine to try to limit that impact. In a recent systematic review on crowding, one of the few actions that was found to be effective, and that lies within the remit of emergency medicine is the idea of enhanced triage [17].…”