Presentation of patients' problems during triage in emergency medicine

•Patients' and accompanying persons' presentations of chief complaints differ.•Accompanying persons provide more extensive descriptions about the complaint.•Patients provide simple descriptions of physical conditions they directly experience.•Accompanying persons provide symptoms they observe with further information.

ObjectiveTo investigate different interactional patterns in presentation of patients' problems depending on whether the presentation is made by patients themselves, or by their accompanying persons.MethodsRoutine provider-patient interactions during triage were video-recorded at an academic emergency department in Seoul, Korea. Using the method of conversation analysis, 242 recordings were transcribed and analyzed in terms of the extent of problem presentation and interactional practices used by the presenting party.ResultsProblem presentation made by accompanying persons was significantly more extensive than that by patients, in terms of its length and the number of symptoms described. Patients tended to describe physical conditions they directly experience, such as pain, whereas accompanying persons tended to provide patients' conditions they observed as a third party, often with more objective information such as medical history.ConclusionCompared to patients who simply present their condition(s), accompanying persons may also communicate their reasonableness in seeking emergency care.Practice implicationsProviders may utilize more facilitative questioning practices to get a fuller array of concerns when interacting with patients. When accompanying persons present the complaint, providers may acknowledge legitimacy of the visit and ask patients directly to better assess the severity of conditions patients themselves experience.