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I almost feel like there is a different use of the word ER in Canada. Patients usually don't stay in ER/ED for long periods, they're released, sent to surgery, sent to ICU, or to Med-Surg. There just aren't that many beds, and you don't want ED to fill up unless the others are already full too (happened with COVID).

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I have an elderly parent who has required multiple trips to the ER in the last year. The issue here (Seattle) is that the beds in the other departments are full, so there is no where else for them to go. The ER usually determine within a few hours she needs to be admitted, and then it takes a day for them to actually find the capacity.

I think the confusion might arise from the definition of "long". People who are stable can spend many hours waiting in an ER. This is a long time. Patients with urgent but not life threatening issues will be seen quickly and discharged quickly, e.g. getting sutures for a nasty cut.

But patients with urgent and life threatening problems, like trauma after a car crash, will receive emergency treatment to stabilize them and then they will be forwarded to another department as soon as possible. How soon depends on hospital capacity, time (day, night, weekend,..), etc.

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