The emergency room at Eastern Hospital is overloaded

Since the beginning of 2024, the number of patients in the emergency medicine and patient reception clinic and inpatients of Riga Eastern Clinical University Hospital (Eastern Hospital) continues to increase. In the first quarter of 2024, compared to the analogous period a year ago, the number of patients who received emergency medical assistance at NMPUK increased by 12%. By 17%, the number of patients who continued to be treated in the Eastern Hospital’s inpatient facilities increased by 17%, and by 17% – to whom emergency assistance was provided due to various serious injuries and accidents. This means that the hospital is overloaded and patients with non-life-threatening or minor injuries and illnesses may have to wait longer, doctors emphasize.

In the first three months of 2024, the Emergency Medicine and Patient Reception Clinic (NMPUK) of Eastern Hospital provided emergency medical assistance to 19,612 patients, or 2,296 more patients than in the first quarter of 2023. 55% or 10,881 patients came to NMPUK by themselves, while 45% or 8,731 patients were transported to NMPUK by Emergency Medical Service (EMS) transport. Thus, in the first three months of 2024, an average of 216 people received emergency care at the hospital every day, of which an average of 96 patients per day were transported by ambulance, while the remaining 120 arrived on their own.

In the first quarter of this year, the number of patients who were brought to NMPUK by NMPD increased by 5%, while the number of people who sought the help of doctors after arriving at East Hospital’s NMPUK by themselves increased by 17%. Almost 60% of these patients went to be treated at home after a doctor’s examination, but only 40% needed inpatient treatment.

3,735 patients – and this is 626 patients more than a year ago – from the total number of emergency patients in the first quarter of 2024 came to the Eastern Hospital due to injuries and accidents, while 594 people – three patients more than a year ago – were in critical condition, they had life-saving procedures and resuscitation measures should be performed.

NMPUK is increasingly being approached not only by residents of Riga or those living in the vicinity of the capital, but also by residents of remote regions of Latvia. In addition, patients often end up at the university hospital not due to an exacerbation of the disease or acute health problems, but probably for various other reasons, thus further lengthening the queues and burdening the doctors. Everyone who comes to NMPUK is provided with medical assistance and advice on how to continue treatment at home, but in these stressful conditions, patients with non-life-threatening or minor injuries and illnesses have to wait longer, and the hospital is overburdened.

“There is a constant and stable trend – the flow of patients is increasing. We often conclude that a large number of patients could get the necessary help from a family doctor or at an outpatient facility. We have also opened additional doctor’s posts and observation beds, but these measures have not reduced the queues either. For a long time, there has been a significant influx of patients in the inpatient flow as well, for example, the occupancy of the inpatient “Gailezers” is currently 87%, but the occupancy of the inpatient “Biķernieki” has never been less than 85%. It should be explained that our hospital is also a NATO strategic partner and we must be ready to respond and provide emergency aid in disaster and crisis situations when there is a large influx of patients at the same time. On the other hand, according to the guidelines, the bed occupancy of the medical institution cannot exceed 80%. Therefore, to reduce the workload of university hospitals, urgent solutions would be needed by strengthening the capacity of the emergency departments of level II and III hospitals,” emphasizes the head of the Emergency Medicine and Patient Reception Clinic of Eastern Hospital, Dr. Aleksej Vishnakovs.

During the busiest hours, which are most often Monday and Tuesday afternoons, patients are admitted at intervals of two to three minutes, so in order to get help first those whose lives are in danger, the NMPUK carries out patient prioritization, during which the severity of the health condition and the potential threat to life are determined . If life is not in danger, the doctor’s examination and examinations can take place over a longer period of time and the total stay in NMPUK, including medical and diagnostic procedures, can exceed four to six hours.

At Eastern Hospital, 16 doctors of specialties currently provide emergency care 24 hours a day, but if necessary, the necessary specialists are also called outside of working hours. Doctors’ assistants, nursing staff, client and patient registrars, security and room cleaning service work in a team with doctors. On average, one doctor’s position may have to provide assistance and refer up to 40 patients for various examinations and analyses, while a nurse can take care of up to 15 patients at the same time.

Among the examples that show the reasons with which, in addition to really serious health exacerbations and traumatic cases, the work of the Department of Emergency Medicine and Patient Admission Clinic of the university hospital is burdened, there are situations when a person needs a sick leave, but he has not registered with a family doctor closer to his place of residence: to should not take the long way to his family doctor, he comes to NMPUK with cold symptoms and, of course, is forced to wait at the reception until he can be seen by a doctor who will give recommendations and open a sick sheet.

There are many people who come to NMPUK with illnesses that can be treated at home, for example, with a cold and a temperature of 37.1 °C. NMPUK has a fixed situation with a patient who has been bitten by fleas, which is far from being a life-threatening or acute medical condition, but it is decided to go and wait in the reception line while NMPUK doctors revive someone who is clinically dead, or a person seriously injured in a traffic accident is rescued patient’s life.

The above-mentioned examples and the statistical data of Eastern Hospital show that a significant proportion of the served patients could contact their family or on-call doctor, receive a consultation and recover at home, but for various reasons choose to go to NMPUK, where doctors will provide medical assistance, as provided by emergency medical guidelines for providing assistance by triaging or prioritizing patients. These people should expect a long wait in line, as these people are currently seeking care at the admissions clinic of the university hospital that they should receive from a family doctor or an outpatient clinic.

The most important factor in triage is the severity of the patient’s current health condition: when a person’s life is in danger or a life-threatening injury has occurred, or there is an acute health condition with a high risk of developing health complications or irreversible permanent consequences, such as the risk of disability.

See how triage or grouping of patients at NMPUK takes place here.

Eastern Hospital’s Emergency Medicine and Outpatient Clinic is the largest emergency care provider in the country. Every year, around 75,000 patients receive emergency care here.

Eastern Hospital provides tertiary, highly specialized care to patients from all regions of Latvia, and at least 10 patients are transferred every day from lower-level hospitals or from call centers if the resources of the nearest medical institution are insufficient. The hospital has a helipad that allows emergency patients transferred from other Latvian cities to be admitted. Continuity of providing emergency assistance to patients is ensured throughout the entire period of their treatment also in basic profile clinics and departments.