Triage A&E question

[MashedPotatoAndBeansAndGravy]

i had to go to a&e a few weeks ago. It was very busy (Friday afternoon) and understandably there was a very long wait to be seen. I have a long term condition which had flared up and I was struggling to breathe. I told the receptionist and sat down gasping for breath as I was starting to feel really tired of trying to get a breath at this point. When this has happened before I was taken for triage quickly, whereas this time it was a 45 minute wait for triage. There were people being seen in front of me for things like a sore finger from a rugby match and a 2 week old sore back- the door was left ajar and with where I was sitting in the waiting area I could hear the conversation (even though I wasn’t trying to) so I know there wasn’t anything else and it was literally a sore finger. I’m NOT disputing that these people should have been seen, of course they should, but I was literally gasping for breath in the waiting area and I thought breathing issues were usually seen quite quickly? Or do some hospitals do triage in order of who presented first rather than who is most unwell etc?

as soon as I was triaged I was taken straight to resus and all sorted. I’m fine now, and am incredibly grateful to the NHS and the amazing staff that helped me.

im just a bit confused though as I thought the wait for triage was usually done by who is most unwell? Previously I was unwell at a different hospital but that’s how they seemed to do it. Or do some hospitals just do it in order of who came first etc?

like I said, 0 complains at all , just curious that’s all!

Triage is supposed to prioritise the most urgent cases ,my nearest A&E has a minor injuries attached for things like sore fingers ws it something like that ?

Some areas of the NHS couldn’t sort out a piss up in a brewery 🤷‍♀️

There are supposed be systems for triage and breathing problems trump a sore finger

I would put in a complaint - asking for them to justify the wait but then I’m sick of paying into a system which isn’t fit for purpose and leaves people waiting over a year for a cancer diagnosis which is what is going on with my DH

I thought triage they see people as they come in & the whole point of triage was that they then assess who is most unwell for order of priority to see the doctor x

Our 'A&E' is actually a combination of A&E, minor injuries and out of hours GP. I went for a suspected broken ankle (turned out to be just a nasty sprain) and got a lot of disgruntled looks from people who'd been in the waiting room a lot longer than I had and with potentially more serious conditions, as I got seen within the hour and they'd been waiting a good while.

I wasn't skipping the queue at A&E, just being dealt with by a different department.

Maybe it's similar at yours?

There's variation in how EDs run their triage process across the country and depending on how busy they are that plan can change/escalate through the night. What you're seeing is just how busy it is now - the initial triage is just streaming - sorting minors inj/minor illness/majors/resus - it's supposed to happen just after booking in but delays occur and then you join the respective departments queue - i.e. finger injuries can be seen treated and discharged with their fracture clinic referral before the patient in majors with the chest pain 'feels just like my last heart attack' is reviewed because the respective queues are different lengths.

I work on the ambulance service - several times this year we've been in situations where we're queueing outside with patients about to go into cardiac arrest because there's no room in resus. It can just be really really busy and there can be a seemingly constant stream of patients with complaints like chest pain/dizzy/sob which in years gone past would have been seen and triaged with onset, and this is before winter pressures. As part of winter escalations this year we're expecting patients to be dropped at hospital without any clinical handover since this takes too long - whilst we've always done this with minor injuries we're only going to wait 30mins with those who are actually very unwell and then leave you in the waiting room if handover not taken (last year we were waiting 2-6hours for handovers hence the change). So experiences may vary - presentations just a few years ago who would have been reviewed straight away can no often be waiting hours before review in hospital.

As you say finger was a minor injury - it wouldn't be taking up a spot in resus but they will be taking up a seat in the waiting room. They run them through triage so they can be sent over to minor injuries and get seen.

A&Es are very busy/beyond capacity most of the time. Essentially too busy for them to meaningfully make a difference themselves because to fix it you need to - increase GP capacity/ooh services, increase public education on health to improve peoples ability to manage with minor inj/illness, fix social care/care home so elderly frail/bed blocking doesn't occur anymore & wards have capacity for A&E to quickly move patients onto as indicated - build more hospitals to cater for larger population, train more staff to work in them, improve immigration opportunities to make our country more attractive to international workers, improved working conditions so British staff stop being poached from abroad.... the list goes on.

Yes as others said the A&E's near me have minor injuries etc running from the same waiting area but actually being triaged and dealt with by different teams, my DS had broken his ankle recently and I phoned 111 when it happened and was given an appointment for an x ray for the following morning which we sat in the A&E waiting room for an hour for but to other people it could have looked like we "skipped the queue"

In my triage you are seen as the order you come in. Our reception give a score and anyone on 1 gets seen urgently the rest is in a queue . It’s the best way as it stops people jumping the queue.

In the UTC I worked in you got a quick triage at the front door by a clinician, not a receptionist. They determine where you need to be seen and do yours obs as well. Those who are too unwell to be seen by the UTC are sent A&E. Then I think their triage is in order of arrival. However being seen by a clinician at the front door helps to highlight those big sicks who need to be seen immediately/very quickly and they will bypass who have been waiting before. I think all departments work a bit differently.