Objective: To determine which of three commonly used methods for notifying medical staff of the arrival of an emergent case to the triage area of an emergency department (ED) is optimal.Methods: Prospective, randomised trial. Patients arriving with conditions rated as emergencies (triage category 2) were randomised to one of three notification arms: by microphone, by telephone, or by computer. The proportion of patients seen by a doctor within 10 minutes of arrival to the ED in each arm was compared.Results: A total of 1000 patients were enrolled. The proportion seen within 10 minutes for patients announced by microphone was significantly greater than those announced by telephone or computer (67.0% v 63.2% v 57.3%, respectively; χ2 6.30, p = 0.04). No method achieved the benchmark proportion of 80% of patients seen within 10 minutes of arrival.Conclusions: A microphone announcement heard by overhead speakers should be incorporated with other strategies to improve the timeliness of medical assessment of emergent cases.