Australian Health Care Agreements
Emergency departments
This page is part of The State of our public hospitals, June 2005 report and contains information on emergency departments in public hospitals.
When it is an emergency
Emergency departments in public hospitals save lives and prevent serious disabilities.
Emergency departments are primarily set up to help people who are experiencing a medical emergency that is life threatening or could cause serious disability. For a variety of reasons, they can also treat a range of other patients. But everyone understands that the priority is to treat patients who have the most urgent medical needs.
If you go to an emergency department, a nurse will assess your medical condition and assign you to an 'urgency' or 'triage' category. There are five triage categories defined by the Australian College of Emergency Medicine. They range from patients who require resuscitation (triage category 1) to patients whose medical needs are not urgent (triage category 5). For each of these categories, the Australian College of Emergency Medicine has identified the maximum time patients should wait until they are seen by a nurse or a doctor for treatment.
This means that if someone arrives after you, but is assigned to a more urgent triage category than you, then they will probably be treated before you. These categories can also be used to benchmark performance.
Emergency department triage categories
- Triage category 1: need for resuscitation - patients seen immediately. People in this group are critically ill and require immediate attention. Most arrive at the emergency department by ambulance. This group includes people whose heart may have stopped beating, whose blood pressure may have dropped to dangerously low levels, who may be barely breathing or have stopped breathing, who may have suffered a critical injury or who may have had an overdose of intravenous drugs and be unresponsive.
- Triage category 2: emergency - patients seen within 10 minutes. People in this group will probably be suffering a critical illness or very severe pain. For example, the group includes people with serious chest pain likely to be related to a heart attack, people with difficulty breathing and people with severe fractures.
- Triage category 3: urgent - patients seen within 30 minutes. People in this group include patients suffering from severe illnesses, people with head injuries but who are conscious, and people with major bleeding from cuts, major fractures, persistent vomiting or dehydration.
- Triage category 4: semi-urgent - patients seen within 60 minutes. People in this group usually have less severe symptoms or injuries, although the condition may be potentially serious. Examples include people with mild bleeding, a foreign body in the eye, a head injury (but where the patient never lost consciousness), a sprained ankle, possible bone fractures, abdominal pain, migraine or earache.
- Triage category 5: non-urgent - patients seen within 120 minutes. People in this group usually have minor illnesses or symptoms that may have been present for more than a week, like rashes or minor aches and pains. The group includes people with stable chronic conditions who are experiencing minor symptoms.
Top of page
How many patients attend emergency departments?
Emergency departments have got busier over the last five years.
In 2002-03, more than 3.8 million Australians went to an emergency department for treatment - 10 per cent more than in 1998-99. Over the past five years, the Northern Territory experienced a slight decrease in attendances while the Australian Capital Territory witnessed the largest increase (17 per cent).
Interestingly, there were significant variations in the percentage change in emergency department attendances by triage category (Figure 13). Nationally, attendances in triage categories 1, 2, 3 and 4 increased (by 2 per cent, 45 per cent, 24 per cent and 5 per cent, respectively), while triage category 5 attendances decreased by 11 per cent.
| Note: The national emergency department attendance trends reported here do not include data from Queensland and Western Australia. This is because those states changed their coverage during the five years, making comparison difficult. |
This means that there has been a large increase in emergency and urgent cases and a decrease in non-urgent cases in emergency departments. These trends may reflect changes in the willingness or capacity of people to use emergency departments when seriously ill, the supply of alternative places of care and treatment, especially after hours, and the effect of increasing waiting times on non-urgent attendances.
Figure 13: Emergency department attendances in Australia from
1998-99 to 2002-03
Source: Australian Government Department of Health and Ageing, Australian Health Care Agreements (AHCA) data reported by the states and territories.
