Talk:Emergency department

Peer Review
According to the peer review linked above, the article is currently lacking information on the history of the ED (inception, development, etc.) and the media impact on public perception of the ED. Any ideas on these two points? Kerowyn 02:30, 24 December 2005 (UTC)

Collaboration to improve article
I have already commenced initial changes to this article. Clearly, it will need a great deal of work before it will be possible to consider it for featured article status. Clearly, a topic of the importance of the emergency department which is critical to preserving the health of so many in our world will require a comprehensive article detailing the different types of ED worldwide. To commence this drive I have started a new category of emergency physician wikipedians. Please come and tell us about EDs in your part of the world and add more detail to the article.--File Éireann 19:14, 29 October 2005 (UTC)
 * I'll try to contribute what I can (exams coming up). I work at a hospital now...but don't have a camera currently for a nice picture of the emergency sign. I"ll probably be most useful for wikification/grammar. --CDN99 05:12, 24 November 2005 (UTC)
 * Regarding ED worldwide, I think the best way to get that information is to search for Wikipedians who are from non-English speaking parts of the world (since that's currently where the article is focused) and who are also nurses, physicians, etc. Kerowyn 02:27, 24 December 2005 (UTC)

If you want a link to stuff about people waiting in the Ed try www.warwick.ac.uk/go/edwaits

Golden hour and trauma center
I have made some comments on the Talk:The Golden Hour page regarding The Golden Hour and how it relates to the emergency room. If anyone is knowledgable in this area then please read and comment. Thank you.

I also think that there is a need to have a seperate entry for trauma center. All trauma centers are emergency rooms but not all emergency rooms are trauma centers. I remember, from my EMT training that there are different levels of trauma centers as well but do not remember them. I also remember that at Denver General (a trauma center that was used as an example in my EMT class and located in Denver, Colorado) that you have something like a 90% survival rate if you still have a pulse after reaching their trauma center from suffering trauma to the heart. In other words: if you were to be stabbed through the heart, something that is almost always fatal, in Denver General's trauma center there would be a 90% chance that they could repair the damage. (My memory of the actual percent comes from a nine year old memory and as such I don't feel comfortable using it in the actual entry.)

I also believe that a trauma center entry should contain the various levels of care that each level of a trauma center is able to provide care for, the needed staff to support that level of trauma center, and the various other hospital services that are required for that care beyond the trauma center. For example: a burn unit is required to further the care that a trauma center starts on a burn victim; a quarantine area is needed to even treat someone infected by a particularly nasty contagious disease like smallpox (as well as a micro-biology lab, flaming air conditionaing exhaust systems (the exhausted air must get hot enough to destroy any possible microbes), etc.), a hazardous materials unit is required to treat exposure to some of the more nasty chemicals (possibly terrorist weapons) as the staff needs to be decontaminated after they treat the patient (hydrofluoric acid is skin soluable and may even permeate latex gloves), etc..

Tres (please email me if you make a comment at class5@pacbell.net)

copied trauma center comments over to Talk:Trauma Center


 * I think the difference lies in that a hospital is designated as a trauma center, and the emergency department is a part of the hospital. But there definately needs to be a section about trauma centers and the difference between them on the ED page. Does anyone have a text source for the defination? Kerowyn 23:42, 13 November 2005 (UTC)
 * After boring through the American College of Surgeons site for longer than should be necessary, I found this PDF document, which gives a quick view in lay terms of the requirements for Level I, II, III, and IV facilities. I think it best, based on personal experience with preparation for an ACS certification visit, to emphasize that ACS certification isn't so much about the ED - it's more about how the ED, the surgical department, and the surgical nursing units all work together and the results they achieve. This particular page doesn't speak directly to the ED requirements; that's going to take some digging through the ACS site. I'm willing to help, but it's definitely going to be a collaborative effort. Take a look at some of the documents on the ACS Trauma page and you'll see what I mean. Thoughts? ddlamb 04:13, 25 November 2005 (UTC)

television
ER (television) links here, should it be linked back? Maybe some fiction where an emergency room figures prominently, like a section ==Emergency rooms in fiction==.

Christopherlin 02:06, 12 Apr 2004 (UTC)

Nomenclature

 * This term did not gain in popularity in the United States until the TV show ER aired, and the heavy marketing of the euphemism "ED" for erectile dysfunction by former Senator/Presidential candidate Bob Dole, as a drug company spokesman.

It seems unclear to me whether "This term" is referring to emergency room or emergency department. Also, it should be made clear that Bob Dole was a spokesman on behalf of Pfizer. This sentence needs a rewrite.

Another issue, is the phrase "the internationally recognized term Emergency Department." Aside from the incorrect capitalization, It should be made clear by which standards body it is so recognized.

--Dforest 12:08, 31 October 2005 (UTC)

I have now offered some justification for the term in the article.--File Éireann 20:33, 14 November 2005 (UTC)
 * Actually, this is the first time I've heard that the term "ED" was losing popularity because of possible confusion with erectile dysfunction. At least in the Boston area, "ED" commonly refers to the emergency department, more so than for erectile dysfunction in fact.  Andrew73 22:16, 15 November 2005 (UTC)
 * As an American RN, I have to agree with Andrew73. All the ED physicians and staff I know, including the professional medical and nursing associations, use 'ED'. It's been that way since I started school back in the day, and nobody's told us to stop. And besides, it's not one room. It's a department that takes up a whole bunch of rooms. :-) ddlamb 04:48, 25 November 2005 (UTC)

I have two things to criticise about the last sentences, or rather, one error that occurs twice:

1) "In some countries, including the United States, Canada and increasingly in countries in Europe, a smaller facility that may provide assistance in medical emergencies is known as a clinic." -- What does "in Europe" mean? The UK and Ireland? Then the article should say so. To say that some facility is known as "clinic" in Denmark, France, or Germany does not make any sense (if the idea is that it is called e.g. "clinique" in France, the article should say so).

2) "The term "urgency" instead of "emergency" is used in some latin american countries." -- Same thing, even if that becomes clear in the next sentence. Latin American countries are not English-speaking countries, and to state that they use "urgency" instead of "emergency" simply does not make sense. (Even if the fact as such may be interesting - etymological relatedness does not make two similar words from two languages the same term. Use the Spanish words!) —Preceding unsigned comment added by 92.73.184.7 (talk) 09:49, 25 March 2009 (UTC)


 * Historical terminology still exists across the English-speaking world, especially in vernacular usage. The previously accepted formal term 'Accident and Emergency' or 'A&E' is still the accepted term in the United Kingdom[by whom?], Commonwealth countries and the Republic of Ireland, [...]

So the United Kingdom, the Irish and some other use a "previously accepted formal term", that is "vernacular" and "historical terminology"? Also, they "still" accept such a historical term... When will they finally accept the US standard? This sentence sounds condescending toward these countries (and I'm not from there, not even a native English speaker, hence I will not modify the page). Yves Dubugnon 0:39, 13 December 2014 (UTC)

Photo
Part of the photo caption reads:
 * Even from a distance, the red-and-white emergency sign is prominent.

I don't think it is prominent at all. IMO, it is barely recognizable as a hospital, especially in the thumbnail. I think we should get a new photo or crop the existing one. Dforest 12:56, 6 November 2005 (UTC)

References, ideas
I think that we need to have references for many of these things which most of us know from experience, including layout, etc. Quick pubmed searches haven't been helpful. If someone has an emergency medicine text or journal which gives some basic stats, that would be nice. We could probably add a history section and discuss the move towards EM residencies, etc. The critical conditions needs to be expanded, but the information on MI seems to be too extensive for this article. Probably could divide into different medical categories with one example in each, i.e. neurology - stroke, surgery - AAA, trauma - MVA/gunshot, etc. Brief discussion of the disease with information as to why the emergency room is important for coordinating care which often actually happens elsewhere in the hospital (ie surgery). Just thoughts, I'm going to have a hard time implementing anything because of the holiday, unfortunately! InvictaHOG 12:46, 22 November 2005 (UTC)

Critical conditions handled
I think this section should not have long descriptions of the ED management of every condition. That would bulk the page up pretty badly. Every related article contains (or should contain) a paragraph on the emergency management. Asthma, the cardiac arrhythmias, all sorts of major and minor trauma, etc etc etc can simply be listed with bullets. JFW | T@lk  20:47, 26 November 2005 (UTC)
 * I agree - Even a bulleted list would probably end up being too long. But the section as is doesn't seem appropriate, since it only lists 4 conditions. Leuko 18:54, 7 August 2006 (UTC)

cropped photo
Would this cropped image of the ED be better? Astrokey44 |talk 05:35, 13 December 2005 (UTC)

Picture at the top
What on earth has the current picture at the top of the article got to do with emergency departments in particular? It is simply a picture of a hospital in Germany that doesn't show any signs, definitely not very helpful to the article. We need to show the emergency department interior and the signs, not the wide exterior of a Germany hospital. — Wackymacs 07:50, 15 December 2005 (UTC)

Cases handled
I think there should be some recognition of the fact that (In the UK, at least), major trauma accounts for only 1% of the patients seen; even if it is the bit focused on in medical dramas and the press, I think we should adopt a more balanced view here! --John24601 20:25, 5 January 2006 (UTC)


 * I think the same goes for the US. I don't know who would have data on that sort of thing though. Maybe the CDC or the Department of Health? Kerowyn 03:11, 18 January 2006 (UTC)

Article removed from Good articles
This article was formerly listed as a good article, but was removed from the listing because fails Good Article Criteria 1, 2 & 4. In particular, many Yankocentric terms are left unexplained, and citations are needed to verify ALL claims; eg the assertion that UK A&E departments are popular, that they must treat patients within four hours. Furthermore, the article gives the impression that A&E departments have every magical aid on hand, and that there are very few problems within any department. Finally, there is a poor use of logic when describing the cause and effect of events.

--die Baumfabrik 08:32, 16 June 2006 (UTC)

--- 4 hour wait ---

here is a reference from the commission for health improvement (UK which talks about the 4 hour wait - including the rational for its implementation - perhaps someone can make use of it and add it to the article.

http://www.chi.nhs.uk/Ratings/Trust/Indicator/IndicatorDescriptionShort.asp?IndicatorId=1624

Ditronet 02:21, 28 November 2006

Non-Emergency Use
Is it just me or is the whole "Non-emergency use" section completely opinionated? None of it is cited, including statements like "no other choice" and mentioning that poor people have no other choice. This whole section needs to be cited, drastically, or deleted. That's not to say there's no ER abuse, but it needs bad repairing. Cs92 03:19, 7 March 2007 (UTC)

I agree. It sounds like many people who come to ER are stupid. I worked in hospitals, mostly city ERs, for twenty-three years. Many, (if not most), of my patients came to ER because without insurance, they had no doctor to go to.--W8IMP 03:43, 7 March 2007 (UTC)

The information in the new section seems solid, but the header has become a much poorer fit. Suggesting "Efficiency" or something similar. Phalmy (talk) 14:44, 14 May 2010 (UTC)

Decline of Emergency Rooms
I've heard from friends in the medical profession that hospitals are closing their ERs because they are too costly. I know that EMTALA was recently (last year or two) expanded to include hospitals that don't have ERs which seems to indicate that trend. I did a google search, but couldn't find any solid references. Can someone more knowledgeable perhaps address this? Doctorfluffy 22:50, 28 July 2007 (UTC)

I am not surprised to see that hospitals are losing money on their ER's. As long as we have our "for-profit, sickness care industry" why would any hospital keep a department open which is losing money. I spent 17 years as an RN in the busiest ER in town. Not a week went by that I didn't hear or say, "This don't make no G*t d*mn sense! We need to shut this m*th*r f*ck*r down!" I was disappointed when I saw "Sicko" that they spent little time in U.S. ERs. I could easily have told them more awful stories than could be told in a mere 2 hours.--W8IMP 02:30, 3 August 2007 (UTC)

Casualty in UK
The popular term casualty is no longer considered appropriate by emergency physicians in Australia, the United Kingdom and Ireland.

Stobhill Hospital still calls it Casualty, although it does not receive blue light emergencies. Panthro (talk) 14:54, 14 August 2008 (UTC)

Doctors in Training in Emergency Departments
I have just made a small change to clarify that of the UK doctors in training some will be on an F2 rotation and others on emergency medicine of GP training schemes but the earlier wording seemed to suggest that they were the only ones: they aren't from personal experience. I also know that there were people on other types of training schemes in the US but am not up to date on that. --Doctormonkey (talk) 15:08, 12 January 2009 (UTC)

"nadir between 2:00 am and 6:00 am"?
Is that supposed to mean "the lowest point" or the "worst time period", both of which are definitions of "nadir". Honestly don't know the answer, but I'd assume the former. Someone...please...use a more appropriate word that does not find it's most common usage in Astronomy. Wow. 76.24.169.192 (talk) 01:44, 23 January 2010 (UTC)

Patient experience
This section is somewhat incoherent, and unlike the rest of the article focuses purely on the economical aspect of emergency healthcare. I think it should be at least rewritten and supplied with links to relevant topics, if not moved or scrapped entirely. I feel that the header "Patient experience" in this context should be about things like emergency protocol and the psychological effect of an ER visit to a patient, not an application of economical principles to medical services.

Phalmy (talk) 14:36, 14 May 2010 (UTC)


 * I found the writing of this section entirely incoherent, bordering on vandalism, and deleted it. Though I agree that such as section is a good idea.
 * Robbins (talk) 00:33, 27 May 2010 (UTC)

Capitalization
I notice this article's title still resides at "Emergency department" and disregards the otherwise agreed on proper title "Emergency Department" within the article. I'm pretty sure even MOS:CAPS would have us move the article. It's not just stylization or something. Pixel Eater (talk) 04:17, 30 March 2011 (UTC)


 * I would disagree here, the capitalised version is a style adopted in some places, but a 'Casualty' or 'A&E' operation is an example of an emergency department (sic) and is not an example of an 'Emergency Department'. It should only be capitalised where it is a proper name - "The Cityville Hospital Emergency Department".  The use of 'Emergency Department' is not universal and as noted, there are a number of other naming styles and conventions, meaning that for the purposes of an international encyclopaedia, it should be lower case descriptive.  I would say for consistency, we should lower case the article, and keep the title as is. OwainDavies (about)(talk) edited at 12:57, 30 March 2011 (UTC)

sfss — Preceding unsigned comment added by 198.203.177.177 (talk) 09:14, 6 March 2014 (UTC)

Can ER refuse treatment if someone has bad credit
I was in default for student loans so I have bad credit but can a ER Refuse treatment because of,bad credit — Preceding unsigned comment added by 192.159.150.62 (talk) 18:51, 11 October 2015 (UTC)

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Worldview Tag
I added the Worldview tag as the article is primarily about Emergency Departments in Canada, the US and the UK, with references that appear to support passages about these countries. Rewrites should address emergency services globally and identify what countries a source is discussing, if not all of them. --Airborne84 (talk) 12:59, 1 July 2018 (UTC)

worst waits in the uk
[https://www.bbc.com/news/health-64629144?app=news.health.story.64629144.page 14 Febr. 2023: The golden hour and the worst waits in the uk.] (By Nick Triggle, Libby Rogers and Rob England 4 BBC News) The BBC analysis of data for December and January shows Hull University Hospitals, Wye Valley and Shrewsbury and Telford were worst for A&E waits. The best trust out of the 107 providing data, Northumbria Healthcare, had fewer than 10% waiting more than four hours.

But it is not just the waits in A&E that have proved to be problematic this winter. Outside hospitals, ambulance crews have faced delays handing over patients to A&E staff, while patients who have been seen in A&E and need to be admitted to a ward for further care - by their nature the very frailest - have been forced to endure further long waits to get a bed. HsMstrServ (talk) 20:45, 14 February 2023 (UTC)

Photos not showing
I am using an Android tablet to read this article in the app. Virtually none of the pictures are showing. Only the caption shows and changing the theme doesn't help. Rpsenft (talk) 01:59, 17 April 2023 (UTC)