What to expect at the Emergency Department

Emergency departments across the region work similarly. When you visit the emergency department, below are four steps that you can generally expect:

• Step 1 – Before you go: In order to register, you will need your provincial health card. Check out other documents that you should bring with you before you go to the emergency department.

• Step 2 – Once you arrive: You will first be registered by a clerk. You will then be seen by a registered nurse who will assess and prioritize your condition. This is called triage. Learn how the triage system works. Depending on your triage level, and what else is happening in the emergency department, you may be taken immediately to a treatment room or asked to wait in the waiting room.

• Step 3 – Waiting for treatment : Depending on your condition, you may wait for treatment.

• Step 4  – Receiving treatment: You will receive medical treatment by a doctor or nurse practitioner.

Sometimes, people leave the emergency department before being seen, and they may receive a follow-up call.

Step 1 – Before You Go

Before heading to the emergency department, please have the following information with you if possible to avoid delays:

• Your Newfoundland and Labrador Medical Care Plan (MCP) card, or other provincial health care.
• Your hospital card – this is a coloured card you may have from previous visits. If you do not have this card, you can get it when you visit.
• An up-to-date list of the medications that you take or the bottles containing your medications (medications prescribed by your doctor or other medications such as vitamins that you take regularly).
• Any records that you may have concerning your health.
• Personal medical equipment that you may need while you are in the emergency department.

We encourage you to bring one family member who can provide you with support and assist you if necessary. Family members may be asked to wait in the waiting room for short periods.

Step 2 – Once you arrive

You will be seen by a registered nurse who will assess and prioritize your condition. This is called triage. Emergency nurses are skilled at triage.

Eastern Health uses the Canadian Triage and Acuity Scale (CTAS) as a triage system to prioritize patient care by the severity of their condition or illness. The CTAS system ensures that the sickest patients are taken care of first. There are five levels of triage, with level one being the most severe:

Level I (Critical)

Your life is in danger, or parts of your body may be at risk of deterioration, and you require immediate care. E.g. shock, coma.

Level II (Emergent)

You have a potential threat to your life, or a part of your body, and require rapid medical intervention. E.g. intense chest pain, difficulty breathing, signs of a heart attack.

Level III (Urgent)

Your condition is serious, but not life-threatening. You are feeling significant discomfort and it is affecting your ability to function. E.g. fracture, signs of infection.

Level IV (Less Urgent)

Your condition may relate to age, distress and/or has the potential to deteriorate and would benefit from medical intervention, but you don’t necessarily require immediate care. E.g. minor allergic reaction.

Level V (Non Urgent)

Your health condition is not urgent or may be part of a chronic problem. E.g. gastroenteritis, signs of urinary infection.

Based on your condition, you will be assigned a triage level that helps the doctors and nurses determine when you will be moved to a treatment room in the emergency department, and when you will be seen by a doctor or nurse practitioner.

Depending on your triage level, and what else is happening in the emergency department, you may be taken immediately to a treatment room or asked to wait in the waiting room.

We understand that visiting the emergency department can be stressful. As health providers, we are committed to acting with respect and civility, and ask that you are respectful to our staff and physicians.

Step 3 – Waiting for treatment

Sometimes, patients have to wait to be seen when they visit the emergency department. Let’s work together to create positive interactions and experiences of care. We understand that visiting the emergency department can be stressful.

Sicker patients already in the emergency department, or sicker patients that arrive while you are waiting must receive care first. The length of time you wait is also affected by the number of patients who are in the emergency department.

While waiting, if you have questions or you feel your condition has become worse, please let the triage nurse or a registered nurse know right away.

Step 4 – Receiving medical care

When you are brought into a treatment area in the emergency department, you will receive a more thorough assessment of your condition.

The physician or nurse practitioner will discuss your treatment options and make any follow-up arrangements and referrals as necessary. You may also be referred to a specialist who will decide if you need to be admitted to the hospital.

Leaving the emergency department before being seen

If you decide that the wait is too long and are planning to leave, please let the nurse know. If you leave an emergency department within Eastern Health without being seen by a physician or nurse practitioner you may receive a follow-up call.

Eastern Health and the NL Health Line work together to follow-up with patients who leave an emergency department without being seen by a nurse practitioner or physician. If there are particular concerns about a patient’s condition, a follow-up call will be made to them within 24 hours of their visit to determine whether the patient has received further assessment or treatment. If the individual cannot be contacted, the identified family contact will be called.