<p>It is a scene that unfolds daily in emergency departments (EDs) across the country. A father clutches his unconscious child, desperate for help. An elderly woman, struggling to breathe, is rushed in by her anxious family. A young man, injured in a motorbike crash, is wheeled through the doors. In these moments, the emergency room becomes a lifeline and often the difference between life and death.</p><p>Yet for all its urgency, the emergency room remains widely misunderstood. Emergency medicine is designed to stabilise patients in life-threatening situations, provide immediate treatment, and facilitate further care through appropriate referrals. In Pakistan, however, the ED has increasingly become the default point of entry into the healthcare system, not only for emergencies but also for a wide range of non-urgent concerns.</p><p>This trend is not merely about individual choice. Limited access to outpatient clinics, long waits for specialist appointments, and a lack of trust in nearby health facilities often leave people with few viable options. The ED is seen as more accessible, always open, and more dependable. As a result, many turn to it as their first, and sometimes only, resort.</p><p>Emergency departments are frequently overwhelmed far beyond their intended capacity. This strain undermines the quality of care. When non-urgent cases flood the system, it becomes harder to dedicate adequate time and attention to those in genuine crisis. In such overcrowded settings, the core purpose of emergency care — to deliver swift, life-saving treatment — is put at risk.</p><p>To cope with the relentless patient flow, EDs rely on a triage system. Upon arrival, patients are quickly assessed and categorised by urgency. Those with life-threatening conditions, such as severe trauma, cardiac events, or respiratory distress, are treated immediately. Others are assigned lower priority and may have to wait longer.</p><p>While this system helps ensure that critical cases receive timely care, it can be difficult for patients and families to understand. Waiting in pain while others are seen first may feel unfair, especially when people come expecting prompt attention. This often leads to frustration and a sense of neglect. In most cases, however, triage is doing exactly what it is meant to do: safeguard those at greatest risk.</p><p>The heavy reliance on EDs points to deeper challenges within the healthcare system. A strong and equitable system must offer timely, trusted alternatives for non-urgent concerns. Expanding outpatient services, improving access to primary care, and educating the public on when and how to seek emergency help are all important steps forward.
</p><p>Emergency departments will always play a vital role. But they should not be the only door people feel they can knock on. A truly resilient healthcare system ensures that every person receives the right care, at the right time, in the right place.
</p><p><strong>Author: </strong><span data-teams="true">Dr Shahan Waheed, Assistant Professor and Section Head of Adult Emergency Medicine, </span>AKUH, Karachi.
</p><p><strong>Note:</strong> This article was originally published in <a href="https://jehanpakistan.com/epaper/epaper.php?edition=karachi&date=290825">Jehan Pakistan.</a>
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