Emergency & Urgent Care

It is difficult to estimate how long your wait will be because wait times can vary, and change quickly, due to a number of factors, including:

• The severity of each patient’s condition or illness
• The high number of patients seeking medical attention in other areas of the hospital, which impacts movement through the Emergency Department.
• An incident such as a serious car accident, which can unexpectedly and significantly impact the wait time for others.

Most people arriving at an ED/UCC will follow these steps:

1. Triage (Assessment of your condition by a specially-trained nurse)
2. Registration
3. Consultation with our healthcare team
4. Diagnostic, lab tests as required
5. Diagnosis
6. Treatment begins
7. Discharge or admission
8. You may be requested to wait between some of these stages.
9. If you have respiratory symptoms, you may be asked to wear a mask.

To evaluate your medical needs, the Triage Nurse will ask you for details about:

• The circumstances that brought you to hospital
• Your history of illness or injury
• Whether you have allergies
• Which medications you take

The nurse will also check your temperature, pulse or blood pressure during the triage process.

This is because patients have been moved into the Emergency Department and there may not be any more spaces available at the time you arrive.

Patients are seen on a priority basis, not on a first-come first-served basis. A specially trained Triage Nurse, who is located at the front of the Emergency Department, conducts the initial assessment of the patient.  Canadian hospitals all use the same triage scale when assessing patients to ensure the most urgent cases are seen first. There are five triage levels, Level 1 being the most critical and No. 5 being non-urgent.

Level 1

Critical — obviously life threatening

Conditions requiring resuscitation, including cardiac arrest, shock and major trauma

Level 2

Emergent — potential threat to life or limb

Examples include asthma, altered mental state, chest pain suggestive of heart problems

Level 3

Urgent — a condition or serious problem requiring emergency intervention

Examples include abdominal pain, mild dehydration, kidney stone or shortness of breath

Level 4

Less Urgent — conditions which because of distress or potential for complications would benefit from intervention

Examples include vomiting and diarrhea with no dehydration, bladder infections, lacerations and earaches

Level 5

Non Urgent — conditions which are non-urgent and/or which might be part of a chronic problem

Examples include sore throat and insect bites

The online wait time reflects the most current estimate of how long it will take from the time you are assessed by a triage nurse in the Emergency Department or Urgent Care Centre until you are first seen by a doctor or nurse practitioner inside the ED/UCC. It does not represent the entire length of your visit.

• Tell the Triage Nurse immediately if your condition changes or you begin to feel worse.
• Don’t leave the ED without telling the Triage Nurse and having your condition re-evaluated.
• Don’t eat or drink anything without speaking to the Triage Nurse first — some tests cannot be performed if you have consumed food or beverages.
• Clean your hands frequently with a cleansing solution provided in the waiting area and throughout the ED. Proper hand hygiene is key to prevent and control the spread of infection.
• Have only one friend or family member wait with you, if possible. This will help reduce your own level of stress and prevent overcrowding.
• Please be respectful and courteous to other patients and hospital staff.

To diagnose the patient, the physician or nurse practitioner may order bloodwork, X-rays, ultrasound, and other tests, a process that could take several hours to complete. Throughout this period, the patient could expect to see a number of different members of the healthcare team, including lab assistants, medical imaging technologists and respiratory therapists. The Emergency Department physician may also request a consultation with a specialist in cardiology, for example, if the patient is having heart issues, or an orthopedic surgeon for a serious bone break.

The physician or nurse practitioner will review the test results with the patient and discuss suggested next steps in care. It is at this point that the patient will either be discharged, with instructions for follow-up care if required, or admitted to an inpatient unit. About one in eight patients who come to Niagara Health’s Emergency Departments is admitted.

Like other hospitals, Niagara Health cares for a number of patients who may no longer require the resources of the hospital. Many of these patients cannot be safely discharged to another setting without home care or additional services. And some may need different levels of care and wait in hospital beds for space at other healthcare facilities, such as a long-term care home. Delays occur in the EDs as patients continue to be admitted to an inpatient room but have to wait for patients elsewhere in the hospital to be discharged. This impacts movement through the Emergency Department.

When you come to the emergency room or for any hospital or medical visit, be sure to bring:

• Ontario Health Card
• Medical insurance information if you live outside Ontario
• List of current medications
• Any records you have regarding your health
• Private health insurance cards
• Personal Health Information Card

OHIP covers most hospital services, but there are a few things that are not covered:

• Ambulance charge of $45 (OHIP covers the remainder of the cost)
• Medical equipment such as crutches, casts, knee immobilizers
• Charges for a semi-private or private room if requested by the patient
• Transportation home from the hospital

If you are not covered by OHIP or your OHIP card has expired, you will be charged for your hospital visit. If you receive any of these services, please see the cashier to make payment before you leave the hospital.