Triage is a word well-known to hospital Emergency Departments: "In the emergency department 'triage' refers to the methods used to assess patients’ severity of injury or illness within a short time after their arrival, assign priorities, and transfer each patient to the appropriate place for treatment." Modern Triage in the Emergency Department, a review published in the U.S. National Library of Medicine of how Emergency Departments across the world define "triage."
According to another study published by the National Institutes of Health in the U.S. National Library of Medicine, many Emergency Departments (ED's) take the position that "Triage of critically ill patients that may limit individual patient and physician choices is justified when (1) the policy is aimed at achieving benefits for individual patients, the health care institution, or society and (2) the policy is announced in advance to notify the public." Access it here.
Triage is really often a choice between who lives, and who dies. Triage is only practiced when emergency services are overwhelmed. When Emergency Departments cannot treat everybody who shows up for treatment, ED's must choose who gets treatment and who doesn't get treatment.
That choice is a fact known to ED's all over the world. It is understandable that hospital Emergency Departments do not mention that fact in their descriptions of the triage they practice.
Hospital Emergency Departments already practice triage, there is no doubt. The prevailing policy at the present time in the United States seems to be First Come, First Served. See the article posted here on December 30, 2021. ED's in the U.S. practice triage by choosing to treat the first people that present themselves as patients. Others who come later have to stand in the back of the treatment line, assuming they ever get in.
As things stand at the dawn of this New Year, people who need immediate treatment may never get it in time. If they did not need immediate treatment, they probably would not have gone to the Emergency Department. We have a catalogue of records from 2020 and 2021 to show the nation what this means in the pandemic. It means that some of us who got all the vaccines, were boostered, and practiced all the measures recommended to fight Covid, still die from conditions unrelated to the pandemic because people who chose not to get vaccinated are taking up all the beds with Covid infections.
Corporate media report that entire health systems are overwhelmed and that others are getting there in this country. The media also report that hospitals, nurses, and doctors are overwhelmed because so many unvaccinated people are infected and assigned to beds in the hospitals, crowding out everyone else.
However corporate media are not reporting the unpleasant fact that people who chose not to get vaccinated in a pandemic are becoming infected at such high rates that the triage procedure of First Come, First Served means that some people who desperately need treatment will be turned away, and others will die because the ED's choose First Come, First Served triage.
So far, we have anecdotal reports to prove that this is happening. A man in Alabama "died of a cardiac emergency in September after he was turned away from 43 hospitals in three states." A man in Iowa was vaccinated, boostered, practiced social distancing and masking; in short, he followed all the best practices in the pandemic, but he had a very hard time finding any hospital that could treat his sepsis condition.
The man from Iowa finally found a small hospital that would admit him, but it lacked all the resources needed to treat him. He was finally admitted to a hospital with the necessary resources, but it took 15 days before they had the room to admit him.
It was too late for him by then. The man from Iowa died.
Triage involves hard choices but that is what triage is all about: Triage only applies when a health care system is overwhelmed and so hospitals, nurses, and doctors simply cannot treat everyone who needs treatment.
- Overwhelmed.
- The health care system cannot treat everyone who needs it.
These two things have to happen before hospitals reluctantly practice triage.
I am loathe to suggest, even now, that anyone should be turned away from the medical treatment they need but some things are crystal clear:
- Hospitals are practicing triage already. By default, they are treating the patients who First Come, and who therefore become the patients who are First Served.
- Patients First Come for treatment because they are infected with Covid and the overwhelming majority of the infected became infected because they chose not to be vaccinated.
- People who need medical treatment are dying already because they did not receive the medical treatment they needed in time.
These things are happening even though people are afraid of a word like triage. Good public policy needs to get beyond fear. If we are going to survive, we need to start thinking and talking about how we are going to survive and about how we want to look as a country after we do.
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