Timbol, Christian R, Baraniuk, James N · Open access emergency medicine : OAEM · 2019 · DOI
This study surveyed 282 people with ME/CFS to understand their experiences in emergency departments (EDs). About 59% had visited an ED, often due to symptoms like dizziness or severe fatigue. Many patients reported that ED staff didn't understand their illness and sometimes dismissed their symptoms as psychological rather than physical, leading to poor experiences and feelings that they weren't taken seriously.
This is the first systematic investigation of ME/CFS presentations in emergency care settings, identifying critical gaps in ED staff knowledge and documenting widespread patient dissatisfaction. These findings highlight urgent needs for clinical education and appropriate diagnostic protocols that could improve acute care experiences and reduce harm from dismissive care.
This study does not establish causation or prevalence estimates for ME/CFS in general ED populations. The cross-sectional design cannot determine whether poor ED experiences cause worse health outcomes, and the online survey methodology may not represent all ME/CFS patients, particularly those too severely affected to complete surveys.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Timbol, Christian R & Baraniuk, James N (2019). Chronic fatigue syndrome in the emergency department.. Open access emergency medicine : OAEM. https://doi.org/10.2147/OAEM.S176843
BibTeX
@article{mecfsatlas-timbol-2019-chronic-fatigue,
author = {Timbol, Christian R and Baraniuk, James N},
title = {Chronic fatigue syndrome in the emergency department.},
journal = {Open access emergency medicine : OAEM},
year = {2019},
doi = {10.2147/OAEM.S176843},
note = {PubMed: 30666170},
url = {https://www.mecfsatlas.com/evidence/timbol-2019-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/timbol-2019-chronic-fatigue
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