The emergency physician’s role in the blue zone of the Emergency Department

Abstract

Background. The blue zone is part of the triage system in the ED, intended for patients with non-critical, hemodynamically stable conditions, requiring prompt medical evaluation and symptomatic treatment. Emergency physician is essential in the efficient management, to avoid overloading other departments of the ED. Objective(s). To evaluate the role of the emergency physician in the management of patients triaged in the blue zone, analyzing frequency, typology of pathologies, interventions applied, post-assessment guidance. Materials and methods. The study was conducted in the ED of the IEM, during 2024, through a prospective analysis of 30141 cases managed in the blue zone. Data were collected on the diagnosis at presentation, investigations performed, initial treatment applied, rate of subsequent surgical interventions and the coordinating role of the emergency physician. Results. In 2024, the Emergency Department recorded 80,080 visits, with a daily average of 219.7 ± 15.3 patients, of which 37.6% (30,141) were classified in the blue zone (106.6 ± 12.4/day). Common conditions included sprains/ligament strains (28.5%), contusions (26.1%), superficial wounds (14.6%), dislocations (11.2%), minor dental/OMF issues (11.7%), and simple fractures (7.9%). Interventions included immobilizations (31.7%), symptomatic treatment (78.4%), and minor surgery (4.9%). The presumptive diagnosis was clinical in 71.3%, later confirmed by imaging. The emergency physician ensured triage, clinical evaluation, and coordinated care. Conclusion(s). The emergency physician in the blue zone has a central role in the decision-making process, ensuring initial treatment, coordinating investigations, and redirecting the patient to the specialist. Professionalism and rapid response in this area contribute to the efficiency of the entire UPU system.