Delayed Evaluation of Abdominal Pain in an Elderly Patient. Liliya Klimkiv, MD, Garth Utter, MD, MSc, and David K. Barnes, MD | September 27, 2023

Delayed Evaluation of Abdominal Pain in an Elderly Patient. Liliya Klimkiv, MD, Garth Utter, MD, MSc, and David K. Barnes, MD | September 27, 2023 https://psnet.ahrq.gov/web-mm/delayed-evaluation-abdominal-pain-elderly-patient This WebM&M Case describes an older adult patient with generalized abdominal pain who was eventually diagnosed with inoperable bowel necrosis. Although she appeared well and had stable vital signs, triage was delayed due to emergency department (ED) crowding, which is usually a result of hospital crowding. She was under-triaged and waited three hours before any diagnostic studies or interventions commenced. Once she was placed on a hallway gurney laboratory and imaging studies proceeded hastily. Catastrophic bowel necrosis was eventually identified, yet she was not moved to a standard ED treatment bed for another 25 minutes. Despite aggressive resuscitation, the surgeon determined that operative intervention was futile, and the patient died a short time later. The commentary highlights how hospital crowding and ED boarding can lead to delayed triage and inefficient ED throughput, which compromises patient safety and summarizes approaches to improving ED triage and throughput.