Death in the Waiting Room: ACEP Responds

A press release from the American College of Emergency Physicians (ACEP):

The death of an Illinois woman in an emergency department waiting room has generated questions about what emergency patients should do if they are waiting and their medical conditions worsen. To address these concerns, the president of the American College of Emergency Physicians (ACEP) President Rick Blum, MD, FACEP, today issued the following statement:

"First, my heart also goes out to the family of Beatrice Vance. I know what it's like to lose a loved one. Emergency physicians and nurses are dedicated to saving lives, and we treat more than 110 million patients each year.

"Second, we don't know the facts about what happened in Illinois, so it's impossible to speculate about it. However, emergency physicians have been sounding an alarm for years about the growing crisis in our nation's emergency departments. We issued a national report card on the state of emergency medicine earlier this year, and the Institute of Medicine released three major reports in June about the fragmentation and lack of capacity to deal with day to day emergencies, let alone an act of terrorism. The biggest threats to the quality of care in emergency departments are the issues raised in these reports.

"All emergency departments use a triage process, which means the most critically ill or injured patients are seen first. So a person with chest pains, stroke symptoms, or any other symptoms of a life- or limb-threatening emergency will go to the front of the line.

"However, sometimes a patient will come in with mild symptoms, and while they are waiting, their medical condition worsens. It's very important for emergency patients in waiting rooms to notify the triage nurse if they are in pain or if they start to feel worse. If they are still concerned, they should ask to speak to an emergency physician or a patient advocate. People should not leave the emergency department without being seen.

"Having health insurance does not mean you will be seen quicker. All emergency patients are equal, regardless of whether or not they have health insurance or can pay. This is mandated by a federal law. People with less urgent medical conditions must wait in the waiting room until all the critical patients have been stabilized and admitted to the hospital.

"The lack of capacity in our emergency departments affects us all. The gridlock stems from the closure of nearly two hundred thousand inpatient hospital beds, as well as the shortages of on-call specialists and nurses.

"Finally, emergency physicians and nurses go into emergency medicine to save lives. To criminalize their efforts would be a terrible mistake and have a severe chilling effect on people going into the medical field."

"ACEP also is advocating for passage of the Access to Emergency Medical Services Act (HR 3875 and S. 2750), and we have asked the public to show their support for having emergency care available when they need it by sending messages to their political leaders, which they can do at our Web site www.acep.org.