User Guide

Emergency

ER triage, boarding, and disposition — the third specialty kiosk.

A.1 What an Emergency doctor / nurse owns

Responsibility	Detail
ER triage board	The single screen they sign in to. One row per active emergency case, colour-coded by triage level (critical / urgent / standard / non-urgent). Banner shows the four counts.
Pending Triage queue	Patients admitted as `emergency` from Reception who haven’t been triaged yet. Each row has an + Add Triage button that opens the triage form pre-filled with the admission.
Patient chart	A popup that opens when they click a patient name. Holds Triage snapshot, Vitals, Allergies, Conditions, Nursing Assess., Medications, Lab/Imaging Orders, Results, Care Plans, Consents.
Recording observations	They can add new vitals, allergies, conditions, and nursing assessments directly from the chart popup. Vitals form has a `GCS` chip alongside the standard BP/HR/Temp/SpO2/RR/Pain.
Placing orders	The `+ Order` button on each row opens Quick Orders (Prescription / Lab / Imaging). Pharmacy / Laboratory / Radiology are notified but invisible to the ER clinician.
Disposition	Three transfer buttons on each row: To ICU, To Operation, To Ward. Each opens a structured handoff form (severity for ICU, surgery type for OR, ward type for stepdown).
Discharge	Removing the case (or transferring out) ends the ER encounter.

A.2 What they cannot do

The Emergency shell is intentionally narrow — kiosk-style, like ICU and Maternity:

No sidebar, no global navigation, no dashboard.
No access to lab, pharmacy, radiology, billing, HR, or admissions screens.
No access to other wards (ICU, Maternity, Operations) — except through the structured transfer buttons on a case row.
No access to patients who are not on the ER board.

Forbidden URLs land on the standard Forbidden page.

A.3 What the screen looks like

When an emergency doctor or nurse logs in:

┌──────────────────────────────────────────────────────────────────────────────┐
│ M  Mando · Emergency       [ Emergency ]            🔔   Dr. Karim Nasr ┄     │
├──────────────────────────────────────────────────────────────────────────────┤
│                                                                              │
│   ● Emergency Department                              + New Emergency Case  │
│   3 active cases — Triage board overview                                     │
│                                                                              │
│   ┌ Critical (1) ┐ ┌ Urgent (1) ┐ ┌ Standard (1) ┐ ┌ Non-Urgent (0) ┐       │
│                                                                              │
│   ⏱  Pending Triage (1)                                                      │
│   ┌──────────────────────────────────────────────────────────────────┐       │
│   │  Maria Garcia   Room 12 · Dr. Karim N         [ + Add Triage ]   │       │
│   └──────────────────────────────────────────────────────────────────┘       │
│                                                                              │
│   ┌ critical ─ John Smith ─ Dr. Karim N ─ [ critical ] [ ambulance ] ┐       │
│   │ Chief: Chest pain, dyspnoea                                       │       │
│   │ Vitals: BP 92/58 · HR 110 · Temp 38.9 · SpO2 88%                  │       │
│   │ AVPU: alert                                                        │       │
│   │ ─────────────────────  [To ICU] [To Operation] [To Ward] [+ Order]│       │
│   └────────────────────────────────────────────────────────────────────┘     │
└──────────────────────────────────────────────────────────────────────────────┘

Top bar: brand → single static tab “Emergency” → notification bell → user pill → Sign out.

A.4 The day, end to end

Sign in. The system bounces them straight to /emergency. No dashboard.
Read the board. Four triage-level cards at the top show counts. Pending-triage queue under that. Triaged cases under that.
Triage a pending patient. Click + Add Triage → modal opens pre-filled with the admission. Fill chief complaint, AVPU, vitals, triage level, arrival mode, trauma type, current meds, allergies. Save → case appears on the board.
Click the patient name. The chart popup opens with 11 cards: Triage, Vitals, Allergies, Conditions, Nursing Assess., Medications, Lab Orders, Imaging Orders, Results, Care Plans, Consents. Each card shows a count.
Click “Triage”. Read-only snapshot: chief complaint, arrival mode, AVPU, stabilized-at, trauma type, free-text vitals/allergies/meds (the values entered in the triage form), notes. Banner highlights critical or trauma cases. The chart’s bottom hint reminds the user that editing the triage record happens on the board (Edit / To ICU / To Operation / To Ward) and that structured vitals belong in the Vitals card.
Click “Vitals” → + Add. Form has seven chips: BP, HR, Temp, SpO2, RR, GCS, Pain. Click a chip → fields pre-fill → type the value → Save.
Click “Allergies / Conditions / Nursing Assess.” → + Add. Same flow. The Nursing Assess. dropdown adds ER-specific types (GCS, ESI re-triage, Trauma primary survey) alongside the shared ones.
Place an order. Close the chart, click + Order on the row. Three tabs: Prescription, Lab, Imaging. Submit → Pharmacy / Lab / Radiology gets the alert; the ER clinician sees nothing about who’s working on it until the result shows up under Results.
Disposition. When the case is ready to leave the department:
- To ICU → opens the ICU handoff form (severity, ventilator mode, O2 flow, IV lines, isolation, diet…). Submitting creates an ICU detail and moves the patient.
- To Operation → opens the OR handoff form (surgery type, procedure, anaesthesia, anaesthesiologist, scheduled time, room, pre-op diagnosis & instructions). Submitting books the case.
- To Ward → opens the ward handoff form (wing, room, ward type, bed, attending nurse, care plan).
Discharge / delete. If the case was a quick treat-and-release, just delete the record after the patient leaves. The admission record stays.

A.5 Notifications

Inbound (the bell flashes):

New emergency admission landed on the wing — fired by the Reception / Admissions Officer at admit time. The patient appears in the Pending-Triage queue.
Stat lab or imaging result finalised on one of their patients (planned).

Outbound (they create them implicitly):

Placing a Lab order → Laboratory.
Placing an Imaging order → Radiology.
New prescription → MAR / pharmacy queue.
To ICU / To Operation / To Ward transfers each fire department alerts to the receiving team (ICU staff, OR coordinator, ward charge nurse).

A.6 Common pitfalls

“I want to update the triage level.” Close the chart, click Edit on the row.
“I just admitted a patient — why aren’t they on the board?” They are, but in the Pending Triage strip near the top. Use + Add Triage to get them onto the main triage board. The chart’s Triage card is empty until you do this.
“I tried to open the lab page and got Forbidden.” Correct — ER staff place orders but never browse lab/pharmacy/radiology. Use + Order on the row.
“The patient I’m looking for isn’t here.” They aren’t admitted to Emergency. Reception admits patients with admission_type = emergency — until that happens, the patient won’t appear on this board.
“I want to transfer to two places.” A patient can only have one disposition at a time. If the case turns: pick the right destination based on current state, do the handoff, and start a new case if they re-present.