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Emergency Care
Emergency Departments
Public hospital emergency departments meet the immediate
health care needs of the community, including treatment of
medical emergencies and less urgent cases when alternative
care is not available. Non-urgent health matters and ongoing
treatment are best treated by your local family doctor.
What happens at an Emergency Department?
All
patients are assessed on arrival, usually
by a nurse |
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Urgency
of each patient's health condition is identified |
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All
patients are assigned a 'triage' category |
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Category
1 patients treated immediately |
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Category
2-5 patients transferred to a treatment
waiting area |
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The Australasian
College of Emergency Medicine has identified five triage
categories and defined the desirable time when treatment
should commence for patients in each category.
The Government sets targets for hospitals in consultation
with hospital staff and clinical groups, to encourage achievement
of national standards of care. The Government monitors hospital
achievement against these targets for the most urgent patients
(triage categories 1-3), to encourage hospitals to treat
as many patients within the desirable times as possible.
The Emergency
Care performance data section of this site allows you
to search individual public hospitals and view their performance
against the national standards.
Emergency
department triage categories |
National standards
- desirable treatment times |
Targets |
1 Resuscitation
(patient unconscious)
For example:
- heart not beating
- barely breathing
- life-threatening injuries
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Seen immediately |
100
per cent seen within desirable time |
2 Emergency
For example:
- very severe pain
- severe breathing difficulties
- major fractures
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Seen within 10 minutes |
80 per cent seen within
desirable time |
3 Urgent
For example:
- moderately severe blood loss
- persistent vomiting
- dehydration
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Seen within 30 minutes |
75 per
cent seen within desirable time |
4 Semi-urgent
For example:
- less severe symptoms or injuries
- mild bleeding
- foreign body in eye
- sprained ankles
- possible fractures
- abdominal pain
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Seen within one hour |
No target set |
5 Non-urgent
For example:
- minor illnesses or symptoms
- rashes
- minor aches and pains
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Seen within two hours |
No target set |
What happens in the treatment area?
Patients
are examined, assessed and treated by members
of the health care team |
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Some
patients have blood tests, x-rays or other
investigations |
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Some
patients are seen by other health professionals
(e.g. physios, social workers |
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Some
patients are treated and are able to go
home |
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Some
patients are admitted to hospital for
more treatment |
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Treatment in the emergency department
Some patients are treated in the emergency department and
are then able to go home. While there is no nationally agreed
standard for how quickly patients should be treated in the
emergency department, the Victorian Government has set a
standard: from July 2005, hospitals must aim to treat 80
per cent of patients who do not need to be admitted to a
hospital bed within
four hours.
Admission from Emergency Department to Hospital
Beds
Where patients require admission to a hospital bed for further
treatment, hospitals aim to transfer them from the emergency
department to a hospital bed in a timely manner, taking their
condition into consideration.
While there is no nationally
agreed standard for how quickly emergency department patients
should be admitted to a hospital bed, the Victorian Government
has set a standard: from July 2005, hospitals must aim to
admit 80 per cent of patients within eight hours.
Why does hospital bypass happen?
Hospital bypass is a period of time when a public hospital emergency department
can request that ambulances bypass it and take patients to other hospitals.
However, even when a hospital is on bypass, urgent patients will be accepted.
A hospital may request a period of bypass when:
- the emergency department is full and it cannot safely accommodate and
treat more patients
- there are unexpected factors (for example, power failure) that would compromise
the treatment of existing patients in the emergency department
The most frequent reason for requesting hospital bypass is that an emergency
department is full. There are a number of reasons why an emergency department
might be unable to accept more patients.
- Patient numbers in emergency departments often vary. There are times (for
example, during winter) when there can be unusually high numbers of people
coming to emergency department
- Some patients have more urgent or more acute problems than others, which
require the attention of staff.
- In some areas the hospital emergency department is one of the few local
health care providers after hours and on weekends. Patients may come to the
emergency department who would otherwise visit their GP
Other factors relate to the demand on the hospital generally:
- Patients admitted to hospital from the emergency department require a
bed in the hospital. As the emergency department workload is unpredictable
a bed may not be immediately available, and patients may have to wait in
the emergency department until one becomes ready
- Patients in the emergency department may need tests performed or periods
of observation
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