Whenever you or a loved one has an emergency situation, the emergency room of a hospital is likely where you end up. Either by driving or being driven there, or being taken by an ambulance, the emergency department is where the triage occurs. Every single minute counts inside an emergency room. Triage is the process of sorting people by their level of injury and risk, deciding who needs attention first. If this triage process is delayed in any way whatsoever, people can suffer exponentially worse harm and even die.
Understanding the triage process and how it’s conducted in emergency rooms is vital if you or a loved one have been harmed by any triage error. If the emergency room had an issue with its triage process that resulted in further injury or death, this might be medical malpractice. Retaining an experienced medical malpractice lawyer like the attorneys at Thomas Law Offices is a smart move.
How Emergency Room Triage Is Supposed to Work
While patients who enter the ER do not receive any type of tags or numbers physically, they are sorted this way in the system’s logging. If someone comes in with back pain, for instance, they sit behind someone who’s suffering a heart attack or a gunshot wound. Every patient is “tagged” this way by the staff upon reporting. “Triage” itself comes from the French term “trier,” which means to sort or separate.
The sorting usually falls to a single triage nurse. The nurse conducts a rapid assessment, not necessarily even having to examine the individual personally. A triage nurse can usually differentiate someone limping from someone missing a leg. Of course, the worse injury is ahead of the lesser injury. A triage nurse is evaluating multiple factors such as:
- Primary Symptoms: The reason for the visit, like chest pain, shortness of breath, abdominal discomfort, or physical trauma.
- Vital Signs: Physical stats including heart rate, blood pressure, respiratory rate, body temperature, and oxygen saturation levels.
- Medical History: Relevant pre-existing conditions, current medications, allergies, and recent surgical procedures.
- Visual Assessment: General physical appearance, level of consciousness, and signs of distress or pain.
Once a nurse has this information, the patient is then assigned a priority level. Level 1 is most urgent, of course. Level 5 is the least urgent, in non-critical condition. When the triage system works well, people who need life-saving care get it quickly. If there’s any type of hiccup in the system, like a misdiagnosis, a Level-1 patient can be categorized lower and ultimately suffer. This is where malpractice may have occurred.
Common Causes of Delayed Triage in Hospitals
Negligence is in no way necessarily malice. Emergency rooms are high-stress, fast-paced environments. This is especially true in larger cities and urban areas with packed ERs. Negligence can—and does—easily occur due to triage nurses being tired, observing too quickly, or simply missing something. Here are some common causes of delayed triage:
Severe Emergency Room Overcrowding
If a hospital is too crowded, there is just no reasonable way to conduct thorough assessments. By the time a nurse starts looking at one patient, another may roll in with worse injuries. Influxes of patients that exceed capacity and staffing lead to a lot of errors. Even with extra triage personnel, they can still become overwhelmed. This can lead to rushed and incorrect assessments or extensive waiting periods even for Level-1 cases.
Understaffing and Fatigue
Many hospitals are not well-funded at all. They do what they can, but the staff may be reduced to only an attending doctor and a few nurses. If an influx of patients comes in beyond normal capacity, the smaller staff may get things wrong. This is also true when this smaller staff has to work longer hours. Fatigue plays a major role in triage mistakes.
Miscommunication and System Failures
Hospitals need seamless, quick communication to operate effectively. If there’s any miscommunication from the front desk, admin staff, triage nurses, and attending doctors, mistakes can happen. Charts can be lost or mixed up. Pre-existing conditions or allergy information can be overlooked. Bottlenecks from system failures can also occur, delaying clinical evaluations.
Implicit Bias and “Diagnostic Overlook”
Triage nurses can sometimes attribute a patient’s seemingly urgent symptoms to less-urgent things. For instance, a nurse may view a major incident as anxiety or intoxication. People with chronic complaints could be looked at as hypochondriacs or people after pain medication. An individual nurse’s biases can certainly play a role in triage mistakes. No person is totally without bias.
The Severe Medical Risks of Delayed Triage
For patients who are Level-5 and likely in the ER because they cannot afford a family doctor, mistakes in triage do not necessarily affect them. If they do, it may only be a minor inconvenience of having to wait longer. For patients who urgently need care, however, triage mistakes are not mere inconveniences. They’re life-threatening mishaps. Sensitive conditions being left untreated can result in death.
When Delayed Triage Crosses Into Medical Negligence
It’s important to understand that not every hospital screw-up is actual medical negligence. It quite often is, however. Estimates of deaths that occur from medical error in the U.S. alone are between 30,000 and 200,000 per year. It’s frighteningly a lot more common than people realize, though some triage mistakes are not the fault of the triage system.
A good example here would be an individual lying or hiding symptoms, out of embarrassment or perhaps not wanting to give their real information. Triage nurses cannot work off information they’re not presented with. So, there are instances where patients suffer and it’s no fault of the triage system.
On the flip side of that, there are many instances where a hospital or a triage nurse fails. If the hospital doesn’t train staff properly, or overworks its employees, or has a faulty system, etc., this can lead to errors. If you or a loved one have been affected by an ER’s triage system, your best move is to retain a medical malpractice lawyer. A qualified attorney will dig into the incident and thoroughly investigate it. If malpractice was at play, it cannot be hidden.
Everyone’s case is different, and most ERs operate a little differently. If medical malpractice led to injury or death in your case, a good lawyer is the key to finding out and pursuing legal action.
