Emergency rooms: first come, first served doesn’t

Rushing a critically ill or injured loved one to hospital is traumatic and distressing. Knowing what to expect when you get to the emergency room is helpful in alleviating unnecessary stress and this involves understanding triage care.


Bernadette Campbell, Group Nursing Service Manager at Clinix Health Group, says that while we all understand that queuing is a ‘first come, first served’ system, when you’re experiencing a medical emergency you hope to be pushed to the front of the queue. It’s with this in mind that the triage system was first developed.

“Triage systems were introduced worldwide to reduce the waiting time for patients who need critical care when they arrive at emergency rooms. Without the system, patients who need medical attention in understaffed and overcrowded emergency rooms often can’t get the help they need in time.”

According to Campbell, many of the complaints hospitals receive are from patients who feel they’re not attended to quickly enough in the emergency department. This is where triage nurses have the responsibility to determine which emergencies have the greatest urgency.

“Triage nursing is one of the more important roles in hospitals as it requires staff to make quick decisions about the priority of admittance. And while this may seem like an easy task, it can be daunting in an environment which is mostly frenzied and pressurised.

“In the emergency room it’s all about time and how long a patient has to wait to receive medical attention. If patients are categorised correctly according to the triage scale, it decreases the waiting time for critically ill patients. The reality is that health care protocols often make patients feel distant and disconnected from the nursing staff and doctors. However, there is huge benefit – for patients and staff – in prioritising treatment using the triage system.

Characteristics of the ideal triage system:

  • Primarily identifies patients with life-threatening conditions
  • Requires minimal training
  • Easy to use
  • Able to process many patients quickly
  • Provides information regarding services and waiting times
  • Determines appropriate treatment area in the emergency department
  • Decreases waiting area congestion
  • Provides continuity between the roadside (ambulance) and emergency units
  • Encompasses trauma and medical cases