Impact of Emergency Department Overcrowding on Management and Outcomes of Patients Presenting with Chest Pain: A Prospective Consecutive Cohort study

Chest pain is one of the most common reasons people come to the Emergency Department and can sometimes indicate serious, life-threatening conditions such as heart attacks. Quick assessment and timely treatment are crucial to ensure good outcomes. However, many emergency departments, especially in large public hospitals, often face overcrowding due to high patient numbers and limited resources. This overcrowding can lead to delays in care. This prospective observational study will be conducted over one year in the Emergency Department of AIIMS Bhopal. All adult patients presenting directly to the emergency department with non-traumatic chest pain within six hours of symptom onset will be included. The level of overcrowding at the time of each patient’s arrival will be measured using the National Emergency Department Overcrowding Score (NEDOCS), a standardized and validated tool.The study will examine whether higher levels of overcrowding are associated with delays in important steps of care, such as initial triage, electrocardiogram recording, blood tests, doctor evaluation, and treatment decisions. Patient outcomes including length of stay in the emergency department, need for hospital or ICU admission, and in-hospital outcomes will also be assessed. The results of this study aim to highlight how emergency department crowding affects patient care and to support improvements in emergency services to ensure timely and effective treatment for patients with chest pain