Journal of Emergency Practice and Trauma To the Editor

Today, overcrowding in emergencies has turned out to be one of the biggest problems in health systems around the world. In this case, a short and an accessible solution could not be reached. In fact, several basic reasons play a role in such a problem, and eliminating each of them would require long-term planning. This issue not only has a negative effect on the quality of services presented to the patients, but also produces both psychological and physi-cal effects on the emergency staff such as physicians and nurses. In addition, it also causes increased dissatisfaction among referees as well as imposing excessive exhaustion on medical staff (1,2). An increase in the number of unnecessary referees in non-emergency cases is one of the major factors for over-crowding, leading to the distraction of physicians from critical and emergency patients during their visiting time toward the noises of non-emergency referees. Providing low-cost or even free services to all referees and fair cal-culation of costs between emergency and non-emergency cases are considered as some of the factors that increase the expectation level of referees and overcrowding in state emergency centers (3,4). Some solutions to eliminate this prominent problem include performing accurate and timely triage, presence of law enforcement and security, difference in the costs of non-emergency cases, and imple-menting some programs to improve the level of medical culture in the society. Another recognized factor responsible for overcrowding in emergencies is the lack of timely hospitalization, dis-position, and discharge of patients. Unfortunately, most of the emergencies suffer from the shortage of personnel with enough skills, experience, and proficiency in knowl