The Health Sciences North online emergency department online wait time estimates aren’t necessarily reflective of how long patients should expect to wait until they see a physician

A key line on the Health Sciences North emergency department estimated wait time online dashboard reads, “Patients are seen in order of urgency, not arrival.”

This is a key point in understanding wait times, HSN emergency department medical director Dr. Jeffrey Middaugh said.

In light of a cold and flu season joining such things as slips and falls and heart attacks in prolonging wait times in recent weeks, Sudbury.com sought additional insights regarding what patients should expect when they visit the Health Sciences North emergency department.

The estimated wait time on the online dashboard, available by clicking here, represents the 90th percentile wait (the time by which 90 per cent of patients will have seen a physician).

“That is the 90th percentile of all comers in the emergency department regardless of triage,” he said, noting that those classified within most-emergent of the five-level Canadian Triage and Acuity Scale Level (CTAS) will be seen immediately, and those less-urgent will be seen later.

“Anything that’s a CTAS-1 resuscitation, those patients aren’t waiting,” Middaugh said.

“They’re brought in right away, and oftentimes we don’t have space for them when they arrive and we’re scrambling to make space in the moment, which requires a fair bit of co-ordination within the department and the hospital.”

The CTAS is standardized across Canada and is the same scale Greater Sudbury Paramedic Services use, allowing for clearer dialogue between medical professionals.

EMS are typically able to give HSN at least five minutes’ heads up that a patient is coming, whereas patients coming in the door without notice might leave them scrambling.

The following is a brief description of each CTAS level:


Level 1: Life-threatening – Your heart has stopped or you’ve experienced life-threatening trauma
Level 2: Emergency – You have symptoms of a heart attack or stroke, not conscious, having a lot of trouble breathing, or bleeding severely
Level 3: Urgent – You have a head injury, deep cut, chest pain (unrelated to known heart issue), serious infection, urgent mental health concern
Level 4: Less urgent – You have a sprain or break, cuts, pain in back, arm or legs
Level 5: Not urgent – You have a sore throat, ear infection, minor cuts or bumps, prescription refill

Although there are five levels, Middaugh contends there should be 1-100, since no two patients present exactly the same within a wide range of human well-being.

The majority of people in the emergency room are CTAS 2 and 3, he said.

Although patients can typically expect hours-long waits, depending on CTAS level, Middaugh also clarified that treatment begins as soon as people enter the building.

“We’ll have initiated blood work, initiated some kind of other diagnostic test like an ECG for someone having chest pains or difficulty breathing,” he said.

“Patients typically get those tests initiated and started within typically 15 minutes after they’ve been triaged,” he said. “You can be triaged relatively low, and then you get that ECG (Electrocardiogram) and all of a sudden you’ve gone from a CTAS 3 to a CTAS 1 because of something we see something on that.”

On a similar front, patients who notice a change in their condition should reach out to a triage nurse as soon as possible to be re-evaluated to see whether they should be seen earlier.

With long wait times also comes the question of whether everyone in the emergency department should be there and whether some patients might be better suited for walk-in clinics or to wait for an appointment with their family doctor.

“As a medical professional, it’s easy for me to assess myself,” Middaugh said. “It’s not always easy for someone who doesn’t have that knowledge.”

Reluctant to tell anyone not to go to the emergency department, since physicians will see and treat anyone, there are some things Middaugh said patients should consider.

“If it feels like the usual common cold or something that you would normally have called a family doctor for and accepted waiting a few days to see your family doctor, you probably don’t need to come to the emergency department,” he said.

One resource people can use to help them determine where to go is the 811 Health Connect Ontario phone line, which connects callers to a registered nurse 24/7.

For those who do attend the emergency department, Middaugh said long waits are an ongoing reality.

“We know you’re waiting a long time, and everyone in our department is working hard to see patients as fast as we possibly can,” he said. “Try to be kind and patient.”

Tyler Clarke covers city hall and political affairs for Sudbury.com.