"Triage"

I am concerned about Box Hill Hospital's ED triaging system.

My mum called me in the morning to tell me that she had persistent chest pain. She has diabetes, high blood pressure and high cholesterol (all risks for heart disease) and has been having dull chest pain on/off for the last few months. She was supposed to see a cardiologist for tests but put it off as my grandmother was sick then passed away.

I told her to get to hospital straight away. When I called her to check how the tests were going as I thought she'd be categorised as Category 1 according to the state wide chest pain protocol. She told me no one has seen her yet as she has been put in Category 3 (!) and an ECG has not been done. I asked to be put through to the triage nurse to at least do an ECG as it is at least reassuring to exclude heart attack as a cause. She refused to speak to me stating she is busy. She was so abrupt that my mum did not even want to ask for pain relief although her chest pain was increasing!

My mum waited 1. 5-2hrs before she was seen (I still do not know what's happened as at time of writing this).

I have worked in one of the busiest ED's in the country, we see up to 30 chest pain cases a day some times and we put them all in a beds & do a ECG within 15 mins of arrival. Even if the chest pain is not typical of a heart attack, we still do an ECG (although a lot of pain is not a heart attack, not even doctors are fool proof at distinguishing it 100% of the time. I believe any doctor who says that is a fool and should be avoided at all cost) because that 1% of time that it's missed. That's someone's life on the line!

I am not complaining because it's my mum. I am complaining because in my opinion this is bad medicine and shows that the triage nurses are poorly trained about risk assessment. (I looked on the Eastern Health website and even the clinical protocol says new onset chest pain needs to be assessed urgently)

The role of an Emergency Department is to assess risk, relieve pain foremost and to reassure patients and their families. I feel that Box Hill ED failed on all accounts. Being busy is not an excuse. If it wasn't busy, it wouldn't be an Emergency Department.

For the general public, as I tell my own patients, if you have chest pain that's worrying you, call 000. See your doctor or go to ED don't ignore it. Even if it turns out to not be a heart attack it is our job as medical professionals to help you when you are unsure. No one should make you feel silly or a burden because they are busy.