The expanding scope of EMS: decreasing emergency department overcrowding in the United States

In the past, emergency departments (EDs) have been able to deny treatment to patients they didn't deem necessary to receive emergency treatment or patients that were uninsured or underinsured. However, due to laws such as the Emergency Medical Treatment and Active Labor Act (EMTALA), EDs in the United States (US) can't deny patient access to emergency treatment regardless of the necessity of treatment or ability to pay (Teitelbaum and Wilensky, 2013). This, of course, has lead to an influx of patients seeking emergency care, especially ones that can't afford to seek care at a doctor's office. his has forced EDs to face an ever growing problem—overcrowding.

The US population has steadily aged over the past several years and as a result, geriatrics have been a frequent user of EDs. Hampton (2008) suggests that US emergency room (ER) visits by individuals aged 65–74 years would nearly double, from 6.4 million visits to 11.7 million visits by this past year, 2013 (Hampton, 2008: 2 614). This is an astronomical influx of patients and will result in severe overcrowding of EDs, which could debilitate their daily functions. This influx of patients can prevent EDs from assessing and treating critical patients in a timely manner, which could ultimately lead to death or disability. For example, an overcrowded ED will not have the capacity to handle three critical patients that are brought in by emergency medical services (EMS) because of ED rooms being in use; thus, care will be delayed because staff will have to scramble around to clear some rooms out to be able to provide life-saving care to these patients.