Impact of emergency department overcrowding and system collapse on patient mortality and medication errors: a scoping review.

Introduction: Overcrowding in emergency departments (EDs) is a critical public health problem that compromises patient safety. In Latin America, operational saturation is associated with an increase in adverse events. However, original evidence on its direct impact on mortality and drug safety in the adult population is scattered. Objective: To map and synthesise scientific evidence derived from primary studies on the impact of overcrowding and the collapse of emergency departments on mortality and the occurrence of medication errors in adult patients in Latin America. Methodology: A scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR reporting requirements. A systematic search will be performed in PubMed, Scopus, ScienceDirect, and LILACS databases. Only original primary studies published between 2015 and 2026, in English and Spanish, conducted in Spanish-speaking countries in Latin America will be included. Systematic reviews, grey literature and paediatric or neonatal populations will be excluded. Three independent reviewers will carry out the selection of studies and data extraction in five technical domains. Expected Results: The aim is to characterise the most commonly used indicators of overcrowding in the region and their correlation with fatal outcomes. It also aims to identify the types of medication errors that are prevalent during periods of operational collapse. The findings will enable gaps in knowledge to be identified and provide a basis for the development of hospital risk management policies.