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25% of heart attack patients have to wait at least 50 minutes before they are seen by a doctor in
American emergency rooms (ERs), says a report by the Harvard Medical School. The average wait for a
heart attack patient in an ER in 2004 was 20 minutes compared to 8 minutes in 1997 - an increase of
150%. In general, Americans in 2004 had 36% longer ER waits in 2004 compared to 1997. A patient who
was seen by a triage nurse and had been classed as one who needed immediate attention had a 40%
longer wait in 2004 compared to 1997 (from 10 minutes to 14 minutes).

Study author, Dr. Andrew Wilper, Harvard Medical School, explains that these longer waits are not
surprising as there were more emergency room visits in 2004 while at the same time many emergency
rooms closed their doors. Add to this the increasing lack of inpatient bed space and a shortage of
specialists available to treat patients and you have a range of factors contributing to bottlenecks. If an
ER patient is still in the ER a few hours coming in it can mean that that room, that nurse and that
equipment are not available for the next ER patients who has just come in.

In this study the researchers looked at data from for the period 1997-2004, involving 92,173 ER visits
(adults). 18,000 of those visits were deemed to need immediate attention at the time of initial
evaluation - 987 had a heart attack diagnosis.

The team extrapolated the information to the whole of the USA for the 1997-2004 period. Nationally,
there were 332 million ER visits (adult) during that period, of which 67 million needed immediate
attention, and 3.7 million had suffered a heart attack.

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-- In 1994 there were 93.4 million ER visits (adults)

-- In 2004 there were 110.2 million ER visits (adults)
-- In 2004 there were 12.4% fewer hospitals offering ERs round-the-clock (24 hours a day) compared to
1997
In other words, demand grew while supply fell.
Each year, from 1997 to 2004 wait times increased 4.1% (from 22 minutes in 1997 to 30 minutes in
2004).
The authors concluded "Emergency departments are the only place where help is offered twenty-four
hours a day; like Robert Frost's conception of home, 'the place where, when you have to go there, They
have to take you in.' Federal law (the Emergency Medical Treatment and Active Labor Act, or EMTALA)
recognizes this important social role, mandating that EDs accept all patients. However, unless resources
are reallocated to prevent ED overcrowding, the benefits of early intervention for time-sensitive
conditions may be less attainable for all Americans."

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Andrew P. Wilper, Steffie Woolhandler, Karen E. Lasser, Danny McCormick, Sarah L. Cutrona, David H.
Bor, and David U. Himmelstein
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27, no. 2 (2008): w84-w95
published online 15 January 2008; 10.1377/hlthaff.27.2.w84
http://www.medicinenet.com/script/main/art.asp?articlekey=106222

Written by - Christian Norqvist

Copyright: Medical News Today
I am totally disagree in this article because not all the cases in emergency department or emergency
rooms are severe, for example one patient is going to die and the other one is experiencing/suffering
from toothache and he is the one who came first, so as a healthcare provider, we need to prioritize
more the first patient who͛s going to die and save him as much we can. Especially for heart attack
patients, they need to wait for almost an hour just to be seen by the doctor which is causing more
severity to the case of the patient and it may also worsen the case of the patient. Heart attack patients
need immediate attention and care especially in emergency room. So as a nurse, we need to prioritize
which patient will be seen first depends on the severity of their cases or complaints. But if lack of
resources like beds, doctors and nurses, it͛s not the fault of the department anymore, so to prevent
many loads of patients going to emergency room, suggest a program for taking care of themselves such
as good and proper diet and other activities that leads to wellness for a better life. We always say that
͞prevention is better than cure͟. Thank you and good day!!