Emergency Department Consultations in the Green Zone: Frequency, Specialties, and Outcomes

INTRODUCTION: The green zone covers patients with stable vital signs who do not require urgent intervention; however, due to the high number of presentations, this group constitutes a significant portion of the emergency department workload. This study aimed to determine the characteristics of consultations requested for green zone patients in the emergency department and to reveal their impact on emergency department operations.
METHODS: Our study was conducted retrospectively on adult patients who visited the emergency department green zone between June 2024 and May 2025. The demographic characteristics of patients who required consultation, the speciality for which consultation is requested, the time of consultation, the diagnosis code, and patient outcomes were analysed.
RESULTS: In our study, 75,011 green zone applications were reviewed, and it was determined that consultations were requested for 237 patients (0.32%). The most frequently requested speciality was orthopaedics (47.3%), followed by plastic surgery (8.0%), ear, nose, and throat (6.3%), and paediatrics (5.9%). 70% of patients for whom consultations were requested were admitted, and 29.5% were discharged. The rate of admission to the intensive care unit was significantly higher in patients who were consulted by cardiology (p<0.001).
DISCUSSION AND CONCLUSION: Although the consultation rate among green zone patients is low, the majority of these patients have serious clinical conditions requiring hospitalisation. Proper management of the consultation process is important for both patient safety and the efficient use of emergency department resources. Strengthening primary care services may play an important role in the management of low-acuity patients in emergency departments.

Keywords: Emergency medical services, primary health care, referral and consultation, triage