states, high costs are incurred by non-emergency use of the emergency room. the national hospital ambulatory medical care survey looked at the ten most common symptoms for which giving rise to emergency room visits (cough, sore throat, back pain, fever, headache, abdominal pain, chest pain, other pain, shortness of breath, vomiting) and made suggestions as to which would be the most cost-effective choice among virtual care, retail clinic, urgent care, or emergency room. notably, certain complaints may also be addressed by a telephone call to a person's primary care provider. in the united states, and many other countries, hospitals are beginning to create areas in their emergency rooms for people with minor injuries. these are commonly referred as fast track or minor care units. these units are for people with non-life-threatening injuries. the use of these units within a department have been shown to significantly improve the flow of patients through a department and to reduce waiting times. urgent care clinics are another alternative, where patients can go to receive immediate care for non-life-threatening conditions. to reduce the strain on limited ed resources, american medical response created a checklist that allows emts to identify intoxicated individuals who can be safely sent to detoxification facilities instead. overcrowding emergency department overcrowding is when function of a department is hindered by an inability to treat all patients in an adequate manner. this is a common occurrence in emergency departments worldwide. overcrowding causes inadequate patient care which leads to poorer patient outcomes. to address this problem, escalation policies are used by emergency departments when responding to an increase in demand (e.g., a sudden inflow of patients) or a reduction in capacity (e.g., a lack of beds to admit patients). the policies aim to maintain the ability to deliver patient care, without compromising safety, by modifying "normal" processes. emergency department waiting times emergency department (ed) waiting times have a serious impact on patient mortality, morbidity with readmission in less than 30 days, length of stay, and patient satisfaction. the probability of death increases each 3 minutes for 1% in case of major injuries in the abdomen part. (journal of trauma and acute care surgery) equipment in emergency departments follows the prompt treatment principle with the least possible patient transfers from admittance to x-ray diagnostics. a review of the literature bears out the logical premise that since the outcome of treatment for all diseases and injuries is time-sensitive, the sooner treatment is rendered, the better the outcome. various studies reported significant associations between waiting times and higher mortality and morbidity among those who survived. it is clear from the literature that untimely hospital deaths and morbidity can be reduced by reductions in ed waiting times. exit block while a significant proportion of people attending emergency departments are discharged home after treatment, many require admission for ongoing observation or treatment, or to ensure adequate social care before discharge is possible. if people requiring admission are not able to be moved to inpatient beds swiftly, "exit block" or "access block" occurs. this often leads to crowding and impairs flow to the point that it can lead to delays in appropriate treatment for newly presenting cases ("arrival access block"). this phenomenon is more common in densely populated areas, and affects pediatric departments less than adults ones. exit block can lead to delays in care both in the people awaiting inpatient beds ("boarding") and those who newly present to an exit blocked department. various solutions have been proposed, such as changes in staffing or increasing inpatient capacity. frequent flyers frequent flyers are persons who will present themselves at a hospital multiple times, usually those with complex medical requirements or with psychological issues complicating medical management. these persons contribute to overcrowding and typically require more hospital resources although they do not account for a significant number of visits. to help prevent inappropriate emergency department use and return visits, some hospitals offer care coordination and support services such as at-home and in-shelter transitional primary care for frequent flyers and short-term housing for homeless patients recovering after discharge. the role of telemedicine one study found that the implementation of telemedicine services in saudi arabia showed to be effective in reducing emergency department overload by providing medical advices to less- and non-urgent patients and deal with their minor medical issues. in the military emergency departments in the military benefit from the added support of enlisted personnel who are capable of performing a wide variety of tasks they have been trained for through specialized military schooling. for example, in united states military hospitals, air force aerospace medical technicians and navy hospital corpsmen perform tasks that fall under the scope of practice of both doctors (i.e. sutures, staples and incision and drainages) and nurses (i.e. medication administration, foley catheter insertion, and obtaining intravenous access) and also perform splinting of injured extremities, nasogastric tube insertion, intubation, wound cauterizing, eye irrigation, and much more. often, some civilian education and/or certification will be required such as an emt certification, in case of the need to provide care outside the base where the member is stationed. the presence of highly trained enlisted personnel in an emergency departments drastically reduces the workload on nurses and doctors. violence against healthcare workers according to a survey at an urban inner-city tertiary care centre in vancouver, 57% of health care workers were physically assaulted in 1996. 73% were afraid of patients as a result of violence, 49% hid their identities from patients, and 74% had reduced job satisfaction. over one-quarter of the respondents took days off because of violence. of respondents no longer working in the emergency department, 67% reported that they had left the job at least partly owing to violence. twenty-four-hour security and a workshop on violence prevention strategies were felt to be the most useful potential interventions. physical exercise, sleep and the company of family and friends were the most frequent coping strategies cited by those surveyed. medication errors emergency department of dartmouth general hospital medication errors are issues that lead to incorrect medication distribution or potential for patient harm. as of 2014, around 3% of all hospital-related adverse effects were due to medication errors in the emergency department (ed); between 4% and 14% of medications given to patients in the ed were incorrect and children were particularly at risk. errors can arise if the doctor prescribes the wrong medication, if the prescription intended by the doctor is not the one actually communicated to the pharmacy due to an illegibly-written prescription or misheard verbal order, if the pharmacy dispenses the wrong medication, or if the medication is then given to the wrong person. the ed is a riskier environment than other areas of the hospital due to medical practitioners not knowing the patient as well as they know longer term hospital patients, due to time pressure caused by overcrowding, and due to the emergency-driven nature of the medicine that is practiced there.