Regarding the complaint in Borneo Post "Waited 12 hours to receive treatment in Emergency Department, Sarawak General Hospital?"?

There was a complaint in Borneo Post dated 21 May 2010, saying that a patient has waited for 12 hours in Emergency Department, Sarawak General Hospital, in order to received treatment and to be admitted into the ward. However, as a staff in the same department, I would like to give an overview of how the department is functioning.


The overview below reflects the normal system for majority of the patients, however, variety may occur depending on the severity of the disease, the number of staff, and the availability of the beds in different wards.


Emergency & Trauma Department (E&T) or Accident and Emergency Department(A&E) in Sarawak General Hospital (SGH) is in fact the first department to see and screen all the patients before they are either discharged, being observed for hours, or to be admitted into different wards.


It is divided into 3 zones, GREEN, YELLOW AND RED, according to the severity of the patients' condition. GREEN, as the name implies meaning all the non-urgent cases, YELLOW as intermediate and RED is urgent, needing immediate attention. For all the patients arriving at E&T, they are screened by the Triage Center, which will further decide which zone they will go to. The staff in Triage Center are Assistant Medical Assistant(AMA), who are medically trained to identify urgent and non urgent condition. Once they are seen at the Triage Center, patients will be directed to the respective zones.


Normal waiting time for patient in GREEN zone ranges from 15 mins, to 2 hours. In YELLOW and RED zone, waiting time is virtually less than 5 minutes as there will nurses/doctors attending them right after they are pushed into the YELLOW/RED zone. Patient in GREEN zone are mostly discharged back home with medications, with or without an appointment to come back to see the doctors. As for patients in YELLOW/RED zone, most of them will need some specialist input from different discipline, to name a few surgical, medical, paediatric etc. The first doctors who attend the patient are basically House Officer(HO) in E&T. Once patients are seen by HO, the more senior doctors, Medical Officer(MO) will again verify, and agree with the HO decision before further management can be made.


Once the decision has been made that the particular patient needs attention from certain discipline, such as Neurosurgical, the HO will call the doctors from Neurosurgical to come and review the patient, and this is always the time when patients are kept in E&T to be observed and awaiting review. Please be reminded that current SGH is still short of staff, most of the time the doctors on-call are busy in the ward, taking care of unstable patients, at the same time, they need to review new cases coming from E&T.


Apart from that, beds in SGH is always lacking, meaning that when a patient is decided for admission, he/she may not be able to enter the ward if beds are not available.


Thus patient may feel irritated that they are kept in E&T for too long, but in reality many process are going on in order to help and optimize the treatment given to the patients.


In conclusion, this is an overview to the public that how the E&T is functioning. Nevertheless, scenario may differ in reality due to different in severity, number of staff, availability of beds and numerous factors that may contribute to the waiting time to the patients.