Emergency consultations are possible on an on-call basis. They are obtained by simply having the RN order the study during the daytime, or by calling the radiologist after hours. This lab is not run by radiology but is under the jurisdiction of one of the vascular surgeons. These studies are simply ordered during the day, and are obtained after hours by paging the noninvasive vascular tech. There are no overhead announcements or bells going off to announce the arrival of a sick patient.
Patients are obviously triaged and an attempt is made to get the sickest patients seen first.
We all rely on RN triaging to help identify the sickest patients, but part of this responsibility rests with physicians. There is no artificial segregation of these patients from the rest of the ED, nor is there a big production such as a medical team called. You are expected to be able to recognize and treat sick patients. Resource allocation is part of this process, and you must learn how to delegate resources and responsibility when needed. The medical staff at TMH agrees wholeheartedly that it is best to admit patients from the ED expediently when it is safe and appropriate to do so.