From 7989ab918437f15bc5937cdca2ede71a4570dafb Mon Sep 17 00:00:00 2001
From: isaacclad <sense.corporate@gmail.com>
Date: Sat, 18 Jul 2026 17:48:57 +0000
Subject: [PATCH] Ship full Emergency specialty suite on the shared shell.
MIME-Version: 1.0
Content-Type: text/plain; charset=UTF-8
Content-Transfer-Encoding: 8bit

Add ED visit stages, triage-driven routing, vitals, observation, disposition, reports, and print summary so Emergency matches Dentistry’s operational depth without a parallel EHR.

Co-authored-by: Cursor <cursoragent@cursor.com>
---
 .../Care/EmergencyWorkspaceController.php     | 234 +++++++++++++++++
 .../Care/SpecialtyModuleController.php        |  85 +++++-
 app/Services/Care/CareQueueProvisioner.php    |   5 +-
 .../Emergency/EmergencyAnalyticsService.php   | 168 ++++++++++++
 .../Care/Emergency/EmergencyVitalsService.php | 115 +++++++++
 .../Emergency/EmergencyWorkflowService.php    |  76 ++++++
 app/Services/Care/SpecialtyShellService.php   |   4 +-
 .../Care/SpecialtyVisitStageService.php       |  11 +-
 config/care_specialty_clinical.php            |  20 ++
 config/care_specialty_shell.php               |   5 +
 .../care/specialty/emergency/print.blade.php  |  88 +++++++
 .../specialty/emergency/reports.blade.php     |  88 +++++++
 .../emergency/workspace-disposition.blade.php |  68 +++++
 .../emergency/workspace-overview.blade.php    | 117 +++++++++
 .../emergency/workspace-vitals.blade.php      |  67 +++++
 .../specialty/partials/actions-menu.blade.php |  35 ++-
 .../specialty/sections/workspace.blade.php    |   2 +
 routes/web.php                                |   6 +
 tests/Feature/CareEmergencySuiteTest.php      | 241 ++++++++++++++++++
 19 files changed, 1413 insertions(+), 22 deletions(-)
 create mode 100644 app/Http/Controllers/Care/EmergencyWorkspaceController.php
 create mode 100644 app/Services/Care/Emergency/EmergencyAnalyticsService.php
 create mode 100644 app/Services/Care/Emergency/EmergencyVitalsService.php
 create mode 100644 app/Services/Care/Emergency/EmergencyWorkflowService.php
 create mode 100644 resources/views/care/specialty/emergency/print.blade.php
 create mode 100644 resources/views/care/specialty/emergency/reports.blade.php
 create mode 100644 resources/views/care/specialty/emergency/workspace-disposition.blade.php
 create mode 100644 resources/views/care/specialty/emergency/workspace-overview.blade.php
 create mode 100644 resources/views/care/specialty/emergency/workspace-vitals.blade.php
 create mode 100644 tests/Feature/CareEmergencySuiteTest.php

diff --git a/app/Http/Controllers/Care/EmergencyWorkspaceController.php b/app/Http/Controllers/Care/EmergencyWorkspaceController.php
new file mode 100644
index 0000000..08efe19
--- /dev/null
+++ b/app/Http/Controllers/Care/EmergencyWorkspaceController.php
@@ -0,0 +1,234 @@
+<?php
+
+namespace App\Http\Controllers\Care;
+
+use App\Http\Controllers\Care\Concerns\ScopesToAccount;
+use App\Http\Controllers\Controller;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\Emergency\EmergencyAnalyticsService;
+use App\Services\Care\Emergency\EmergencyVitalsService;
+use App\Services\Care\Emergency\EmergencyWorkflowService;
+use App\Services\Care\SpecialtyClinicalRecordService;
+use App\Services\Care\SpecialtyModuleService;
+use App\Services\Care\SpecialtyShellService;
+use App\Services\Care\SpecialtyVisitStageService;
+use Illuminate\Http\RedirectResponse;
+use Illuminate\Http\Request;
+use Illuminate\View\View;
+
+class EmergencyWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertEmergencyAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'emergency'), 403);
+    }
+
+    protected function assertVisit(Request $request, Visit $visit): void
+    {
+        abort_unless($visit->organization_id === $this->organization($request)->id, 404);
+        $this->authorizeBranch($request, (int) $visit->branch_id);
+    }
+
+    public function setStage(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyVisitStageService $stages,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertEmergencyAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'emergency',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'emergency', 'visit' => $visit, 'tab' => 'overview'])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function saveVitals(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        EmergencyVitalsService $vitals,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertEmergencyAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'bp_systolic' => ['nullable', 'integer', 'min:0', 'max:300'],
+            'bp_diastolic' => ['nullable', 'integer', 'min:0', 'max:200'],
+            'pulse' => ['nullable', 'integer', 'min:0', 'max:300'],
+            'temperature' => ['nullable', 'numeric', 'min:30', 'max:45'],
+            'spo2' => ['nullable', 'integer', 'min:0', 'max:100'],
+            'respiratory_rate' => ['nullable', 'integer', 'min:0', 'max:80'],
+            'weight_kg' => ['nullable', 'numeric', 'min:0', 'max:500'],
+            'height_cm' => ['nullable', 'numeric', 'min:0', 'max:300'],
+        ]);
+
+        try {
+            $vitals->record(
+                $this->organization($request),
+                $visit,
+                $this->ownerRef($request),
+                $validated,
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'emergency', 'visit' => $visit, 'tab' => 'vitals'])
+            ->with('success', 'Vitals recorded.');
+    }
+
+    public function saveDisposition(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        EmergencyWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertEmergencyAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('emergency', 'disposition') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'disposition']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('emergency', 'disposition')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'emergency',
+            'disposition',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            EmergencyWorkflowService::STAGE_DISPOSITION,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'emergency',
+                EmergencyWorkflowService::STAGE_DISPOSITION,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+            // Stage already disposition or map empty.
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            $visit->refresh();
+            if ($visit->status !== Visit::STATUS_COMPLETED) {
+                $visit->update([
+                    'status' => Visit::STATUS_COMPLETED,
+                    'completed_at' => $visit->completed_at ?? now(),
+                ]);
+            }
+
+            $appointment = $visit->appointment;
+            if ($appointment && $appointment->status !== \App\Models\Appointment::STATUS_COMPLETED) {
+                $appointment->update([
+                    'status' => \App\Models\Appointment::STATUS_COMPLETED,
+                    'completed_at' => $appointment->completed_at ?? now(),
+                ]);
+            }
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'emergency', 'visit' => $visit, 'tab' => 'disposition'])
+            ->with('success', 'Disposition saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        EmergencyAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertEmergencyAccess($request, $modules);
+
+        $organization = $this->organization($request);
+        $branchScope = app(\App\Services\Care\OrganizationResolver::class)->branchScope($this->member($request));
+
+        $report = $analytics->report(
+            $organization,
+            $this->ownerRef($request),
+            $branchScope,
+            $request->query('from'),
+            $request->query('to'),
+        );
+
+        return view('care.specialty.emergency.reports', [
+            'moduleKey' => 'emergency',
+            'definition' => $modules->definition('emergency'),
+            'shellNav' => $shell->navItems('emergency'),
+            'report' => $report,
+            'currency' => strtoupper((string) config('care.billing.currency', config('care.currency', 'GHS'))),
+        ]);
+    }
+
+    public function printSummary(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        EmergencyVitalsService $vitals,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertEmergencyAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.emergency.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'triage' => $clinical->findForVisit($visit, 'emergency', 'triage'),
+            'clinicalNote' => $clinical->findForVisit($visit, 'emergency', 'clinical_note'),
+            'observation' => $clinical->findForVisit($visit, 'emergency', 'observation'),
+            'disposition' => $clinical->findForVisit($visit, 'emergency', 'disposition'),
+            'vitals' => $vitals->forVisit($visit),
+            'latestVitals' => $vitals->latestForVisit($visit),
+        ]);
+    }
+}
diff --git a/app/Http/Controllers/Care/SpecialtyModuleController.php b/app/Http/Controllers/Care/SpecialtyModuleController.php
index 13ec7bb..28bbeba 100644
--- a/app/Http/Controllers/Care/SpecialtyModuleController.php
+++ b/app/Http/Controllers/Care/SpecialtyModuleController.php
@@ -156,11 +156,13 @@ class SpecialtyModuleController extends Controller
         if ($openConsultation && $openConsultation->status !== \App\Models\Consultation::STATUS_COMPLETED) {
             $clinical = app(SpecialtyClinicalRecordService::class);
             $shellTabs = app(SpecialtyShellService::class)->workspaceTabs($module);
-            $preferredTab = $module === 'dentistry'
-                ? 'odontogram'
-                : (collect(array_keys($shellTabs))
+            $preferredTab = match ($module) {
+                'dentistry' => 'odontogram',
+                'emergency' => 'triage',
+                default => (collect(array_keys($shellTabs))
                     ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
-                    ?? 'clinical_notes');
+                    ?? 'clinical_notes'),
+            };
 
             return redirect()
                 ->route('care.specialty.workspace', [
@@ -214,7 +216,7 @@ class SpecialtyModuleController extends Controller
                 } catch (\InvalidArgumentException) {
                     // Stage map may be empty for some modules.
                 }
-            } elseif ($nextStage && $visit->specialty_stage === 'waiting') {
+            } elseif ($nextStage && in_array($visit->specialty_stage, ['waiting', 'arrival'], true)) {
                 try {
                     $stageService->setStage($organization, $visit, $module, $nextStage, $owner, $owner);
                     $visit = $visit->fresh();
@@ -224,11 +226,13 @@ class SpecialtyModuleController extends Controller
         }
         $clinical = app(SpecialtyClinicalRecordService::class);
         $shellTabs = app(SpecialtyShellService::class)->workspaceTabs($module);
-        $preferredTab = $module === 'dentistry'
-            ? 'odontogram'
-            : (collect(array_keys($shellTabs))
+        $preferredTab = match ($module) {
+            'dentistry' => 'odontogram',
+            'emergency' => 'triage',
+            default => (collect(array_keys($shellTabs))
                 ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
-                ?? 'clinical_notes');
+                ?? 'clinical_notes'),
+        };
 
         return redirect()
             ->route('care.specialty.workspace', [
@@ -285,6 +289,41 @@ class SpecialtyModuleController extends Controller
             $validated['status'] ?? \App\Models\SpecialtyClinicalRecord::STATUS_ACTIVE,
         );
 
+        if ($module === 'emergency' && $recordType === 'triage') {
+            $workflow = app(\App\Services\Care\Emergency\EmergencyWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = $workflow->stageFromTriage($record->payload ?? []);
+            $current = $visit->specialty_stage;
+            if (! $current || in_array($current, ['arrival', 'waiting'], true)) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'emergency',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
+        if ($module === 'emergency' && $recordType === 'observation') {
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            try {
+                $stageService->setStage(
+                    $organization,
+                    $visit,
+                    'emergency',
+                    \App\Services\Care\Emergency\EmergencyWorkflowService::STAGE_OBSERVATION,
+                    $this->ownerRef($request),
+                    $this->ownerRef($request),
+                );
+            } catch (\InvalidArgumentException) {
+            }
+        }
+
         return redirect()
             ->route('care.specialty.workspace', [
                 'module' => $module,
@@ -555,6 +594,14 @@ class SpecialtyModuleController extends Controller
         $dentalLabCaseStatuses = [];
         $dentalRecalls = collect();
         $dentalStageCodes = [];
+        $emergencyTriage = null;
+        $emergencyClinicalNote = null;
+        $emergencyObservation = null;
+        $emergencyDisposition = null;
+        $emergencyVitals = collect();
+        $emergencyLatestVitals = null;
+        $emergencyStageCodes = [];
+        $emergencyStageFlow = [];
         $activeTab = (string) $request->query('tab', array_key_first($shell->workspaceTabs($module)) ?: 'overview');
         $clinical = app(SpecialtyClinicalRecordService::class);
 
@@ -659,6 +706,18 @@ class SpecialtyModuleController extends Controller
                 );
             }
 
+            if ($module === 'emergency') {
+                $emergencyTriage = $clinical->findForVisit($workspaceVisit, 'emergency', 'triage');
+                $emergencyClinicalNote = $clinical->findForVisit($workspaceVisit, 'emergency', 'clinical_note');
+                $emergencyObservation = $clinical->findForVisit($workspaceVisit, 'emergency', 'observation');
+                $emergencyDisposition = $clinical->findForVisit($workspaceVisit, 'emergency', 'disposition');
+                $vitalsService = app(\App\Services\Care\Emergency\EmergencyVitalsService::class);
+                $emergencyVitals = $vitalsService->forVisit($workspaceVisit);
+                $emergencyLatestVitals = $vitalsService->latestForVisit($workspaceVisit);
+                $emergencyStageCodes = collect($shell->stages('emergency'))->pluck('code')->all();
+                $emergencyStageFlow = app(\App\Services\Care\Emergency\EmergencyWorkflowService::class)->stageFlow();
+            }
+
             if ($patientHeader !== null) {
                 $patientHeader['clinical_alerts'] = $clinicalAlerts;
             }
@@ -729,6 +788,14 @@ class SpecialtyModuleController extends Controller
             'dentalLabCaseStatuses' => $dentalLabCaseStatuses,
             'dentalRecalls' => $dentalRecalls,
             'dentalStageCodes' => $dentalStageCodes,
+            'emergencyTriage' => $emergencyTriage,
+            'emergencyClinicalNote' => $emergencyClinicalNote,
+            'emergencyObservation' => $emergencyObservation,
+            'emergencyDisposition' => $emergencyDisposition,
+            'emergencyVitals' => $emergencyVitals,
+            'emergencyLatestVitals' => $emergencyLatestVitals,
+            'emergencyStageCodes' => $emergencyStageCodes,
+            'emergencyStageFlow' => $emergencyStageFlow,
             'queueStubs' => $modules->queueStubsFor($organization, $module),
             'branchId' => $branchId,
             'branchLabel' => $branchLabel,
diff --git a/app/Services/Care/CareQueueProvisioner.php b/app/Services/Care/CareQueueProvisioner.php
index 2bdcfc5..ab5bdb3 100644
--- a/app/Services/Care/CareQueueProvisioner.php
+++ b/app/Services/Care/CareQueueProvisioner.php
@@ -292,11 +292,12 @@ class CareQueueProvisioner
         string $context,
         $priorByKey,
     ): array {
-        if ($context !== 'dentistry') {
+        $stages = app(SpecialtyShellService::class)->stages($context);
+        $hasQueuePoints = collect($stages)->contains(fn ($s) => is_string($s['queue_point'] ?? null) && $s['queue_point'] !== '');
+        if (! $hasQueuePoints) {
             return [];
         }
 
-        $stages = app(SpecialtyShellService::class)->stages($context);
         $seen = [];
         $points = [];
         foreach ($stages as $stage) {
diff --git a/app/Services/Care/Emergency/EmergencyAnalyticsService.php b/app/Services/Care/Emergency/EmergencyAnalyticsService.php
new file mode 100644
index 0000000..5492daf
--- /dev/null
+++ b/app/Services/Care/Emergency/EmergencyAnalyticsService.php
@@ -0,0 +1,168 @@
+<?php
+
+namespace App\Services\Care\Emergency;
+
+use App\Models\Appointment;
+use App\Models\Bill;
+use App\Models\BillLineItem;
+use App\Models\Organization;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyShellService;
+use Carbon\Carbon;
+use Illuminate\Support\Collection;
+
+class EmergencyAnalyticsService
+{
+    public function __construct(
+        protected SpecialtyShellService $shell,
+    ) {}
+
+    /**
+     * @return array{
+     *     arrivals_today: int,
+     *     completed_today: int,
+     *     high_acuity_open: int,
+     *     acuity_distribution: Collection,
+     *     disposition_breakdown: Collection,
+     *     avg_los_minutes: ?float,
+     *     revenue_by_service: Collection,
+     *     from: string,
+     *     to: string
+     * }
+     */
+    public function report(
+        Organization $organization,
+        string $ownerRef,
+        ?int $branchId = null,
+        ?string $from = null,
+        ?string $to = null,
+    ): array {
+        $todayStart = now()->startOfDay();
+        $rangeFrom = $from ? Carbon::parse($from)->startOfDay() : now()->startOfMonth();
+        $rangeTo = $to ? Carbon::parse($to)->endOfDay() : now()->endOfDay();
+
+        $departmentIds = $this->shell->departmentIds($organization, 'emergency', $ownerRef, $branchId);
+
+        $appointmentBase = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->when($departmentIds !== [], fn ($q) => $q->whereIn('department_id', $departmentIds))
+            ->when($departmentIds === [], fn ($q) => $q->whereRaw('1 = 0'))
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId));
+
+        $arrivalsToday = (clone $appointmentBase)
+            ->where('checked_in_at', '>=', $todayStart)
+            ->count();
+
+        $completedToday = (clone $appointmentBase)
+            ->where('status', Appointment::STATUS_COMPLETED)
+            ->where('completed_at', '>=', $todayStart)
+            ->count();
+
+        $visitIds = (clone $appointmentBase)->whereNotNull('visit_id')->pluck('visit_id');
+
+        $triageRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'emergency')
+            ->where('record_type', 'triage')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $acuityDistribution = $triageRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['acuity'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $acuity) => [
+                'acuity' => $acuity,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortBy('acuity')
+            ->values();
+
+        $openVisitIds = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS])
+            ->pluck('id');
+
+        $highAcuityOpen = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'emergency')
+            ->where('record_type', 'triage')
+            ->whereIn('visit_id', $openVisitIds->isEmpty() ? [0] : $openVisitIds)
+            ->get()
+            ->filter(function (SpecialtyClinicalRecord $r) {
+                $acuity = (string) ($r->payload['acuity'] ?? '');
+
+                return str_starts_with($acuity, '1') || str_starts_with($acuity, '2');
+            })
+            ->count();
+
+        $dispositionRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'emergency')
+            ->where('record_type', 'disposition')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $dispositionBreakdown = $dispositionRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['disposition'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $disposition) => [
+                'disposition' => $disposition,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $completedVisits = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->where('status', Visit::STATUS_COMPLETED)
+            ->whereBetween('completed_at', [$rangeFrom, $rangeTo])
+            ->whereNotNull('checked_in_at')
+            ->whereNotNull('completed_at')
+            ->get();
+
+        $avgLos = null;
+        if ($completedVisits->isNotEmpty()) {
+            $avgLos = round($completedVisits->avg(function (Visit $visit) {
+                return $visit->checked_in_at->diffInMinutes($visit->completed_at);
+            }), 1);
+        }
+
+        $serviceLabels = collect($this->shell->provisionedServices($organization, 'emergency'))
+            ->pluck('label')
+            ->filter()
+            ->values()
+            ->all();
+
+        $revenueByService = BillLineItem::query()
+            ->where('owner_ref', $ownerRef)
+            ->where('source_type', 'specialty_service')
+            ->whereIn('description', $serviceLabels ?: ['__none__'])
+            ->whereBetween('created_at', [$rangeFrom, $rangeTo])
+            ->whereHas('bill', function ($q) use ($organization, $visitIds) {
+                $q->where('organization_id', $organization->id)
+                    ->whereIn('visit_id', $visitIds->isEmpty() ? [0] : $visitIds)
+                    ->whereNotIn('status', [Bill::STATUS_VOID]);
+            })
+            ->selectRaw('description, count(*) as total, sum(total_minor) as amount_minor')
+            ->groupBy('description')
+            ->orderByDesc('amount_minor')
+            ->get();
+
+        return [
+            'arrivals_today' => $arrivalsToday,
+            'completed_today' => $completedToday,
+            'high_acuity_open' => $highAcuityOpen,
+            'acuity_distribution' => $acuityDistribution,
+            'disposition_breakdown' => $dispositionBreakdown,
+            'avg_los_minutes' => $avgLos,
+            'revenue_by_service' => $revenueByService,
+            'from' => $rangeFrom->toDateString(),
+            'to' => $rangeTo->toDateString(),
+        ];
+    }
+}
diff --git a/app/Services/Care/Emergency/EmergencyVitalsService.php b/app/Services/Care/Emergency/EmergencyVitalsService.php
new file mode 100644
index 0000000..02c10e1
--- /dev/null
+++ b/app/Services/Care/Emergency/EmergencyVitalsService.php
@@ -0,0 +1,115 @@
+<?php
+
+namespace App\Services\Care\Emergency;
+
+use App\Models\Appointment;
+use App\Models\Consultation;
+use App\Models\Organization;
+use App\Models\Visit;
+use App\Models\VitalSign;
+use App\Services\Care\ConsultationService;
+use Illuminate\Support\Collection;
+
+class EmergencyVitalsService
+{
+    public function __construct(
+        protected ConsultationService $consultations,
+    ) {}
+
+    /**
+     * @return Collection<int, VitalSign>
+     */
+    public function forVisit(Visit $visit): Collection
+    {
+        $consultationIds = Consultation::owned($visit->owner_ref)
+            ->where('visit_id', $visit->id)
+            ->pluck('id');
+
+        if ($consultationIds->isEmpty()) {
+            return collect();
+        }
+
+        return VitalSign::owned($visit->owner_ref)
+            ->whereIn('consultation_id', $consultationIds)
+            ->orderByDesc('recorded_at')
+            ->orderByDesc('id')
+            ->get();
+    }
+
+    public function latestForVisit(Visit $visit): ?VitalSign
+    {
+        return $this->forVisit($visit)->first();
+    }
+
+    /**
+     * @param  array<string, mixed>  $vitals
+     */
+    public function record(
+        Organization $organization,
+        Visit $visit,
+        string $ownerRef,
+        array $vitals,
+        ?string $actorRef = null,
+    ): VitalSign {
+        $consultation = $this->ensureConsultation($visit, $ownerRef, $actorRef);
+
+        $saved = $this->consultations->saveVitals(
+            $consultation,
+            $ownerRef,
+            $vitals,
+            $actorRef,
+        );
+
+        if (! $saved) {
+            throw new \InvalidArgumentException('Enter at least one vital sign value.');
+        }
+
+        return $saved;
+    }
+
+    protected function ensureConsultation(Visit $visit, string $ownerRef, ?string $actorRef): Consultation
+    {
+        $existing = Consultation::owned($ownerRef)
+            ->where('visit_id', $visit->id)
+            ->where('status', '!=', Consultation::STATUS_COMPLETED)
+            ->orderByDesc('id')
+            ->first();
+
+        if ($existing) {
+            return $existing;
+        }
+
+        $completed = Consultation::owned($ownerRef)
+            ->where('visit_id', $visit->id)
+            ->orderByDesc('id')
+            ->first();
+
+        if ($completed) {
+            return $completed;
+        }
+
+        $visit->loadMissing('appointment', 'patient');
+        $appointment = $visit->appointment;
+        if (! $appointment instanceof Appointment) {
+            $appointment = Appointment::query()->where('visit_id', $visit->id)->first();
+        }
+
+        if ($appointment) {
+            try {
+                return $this->consultations->startFromAppointment($appointment, $ownerRef, $actorRef);
+            } catch (\InvalidArgumentException) {
+                // Fall through to draft consultation.
+            }
+        }
+
+        return Consultation::create([
+            'owner_ref' => $ownerRef,
+            'visit_id' => $visit->id,
+            'appointment_id' => $appointment?->id,
+            'practitioner_id' => $appointment?->practitioner_id,
+            'patient_id' => $visit->patient_id,
+            'status' => Consultation::STATUS_DRAFT,
+            'started_at' => now(),
+        ]);
+    }
+}
diff --git a/app/Services/Care/Emergency/EmergencyWorkflowService.php b/app/Services/Care/Emergency/EmergencyWorkflowService.php
new file mode 100644
index 0000000..eadd2db
--- /dev/null
+++ b/app/Services/Care/Emergency/EmergencyWorkflowService.php
@@ -0,0 +1,76 @@
+<?php
+
+namespace App\Services\Care\Emergency;
+
+/**
+ * Map triage acuity / intent onto Emergency visit stages.
+ */
+class EmergencyWorkflowService
+{
+    public const STAGE_ARRIVAL = 'arrival';
+
+    public const STAGE_RESUS = 'resus';
+
+    public const STAGE_TREATMENT = 'treatment';
+
+    public const STAGE_OBSERVATION = 'observation';
+
+    public const STAGE_DISPOSITION = 'disposition';
+
+    /**
+     * Suggested next visit stage after a triage payload is saved.
+     *
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromTriage(array $payload): string
+    {
+        $acuity = (string) ($payload['acuity'] ?? '');
+        $intent = strtolower((string) ($payload['disposition_intent'] ?? ''));
+
+        if (str_starts_with($acuity, '1') || str_starts_with($acuity, '2') || str_contains($intent, 'resus')) {
+            return self::STAGE_RESUS;
+        }
+
+        if (str_contains($intent, 'observation')) {
+            return self::STAGE_OBSERVATION;
+        }
+
+        if (str_contains($intent, 'discharge') || str_contains($intent, 'admit') || str_contains($intent, 'transfer')) {
+            return self::STAGE_TREATMENT;
+        }
+
+        if (str_contains($intent, 'treatment')) {
+            return self::STAGE_TREATMENT;
+        }
+
+        return self::STAGE_TREATMENT;
+    }
+
+    /**
+     * Whether a disposition payload should close the visit episode.
+     *
+     * @param  array<string, mixed>  $payload
+     */
+    public function shouldCompleteVisit(array $payload): bool
+    {
+        $disposition = strtolower((string) ($payload['disposition'] ?? ''));
+
+        return $disposition !== '';
+    }
+
+    /**
+     * Default stage progression for action buttons.
+     *
+     * @return array<string, array{next: string, label: string}>
+     */
+    public function stageFlow(): array
+    {
+        return [
+            self::STAGE_ARRIVAL => ['next' => self::STAGE_TREATMENT, 'label' => 'Move to treatment'],
+            self::STAGE_RESUS => ['next' => self::STAGE_TREATMENT, 'label' => 'Move to treatment bay'],
+            self::STAGE_TREATMENT => ['next' => self::STAGE_OBSERVATION, 'label' => 'Move to observation'],
+            self::STAGE_OBSERVATION => ['next' => self::STAGE_DISPOSITION, 'label' => 'Ready for disposition'],
+            self::STAGE_DISPOSITION => ['next' => self::STAGE_DISPOSITION, 'label' => 'Complete disposition'],
+        ];
+    }
+}
diff --git a/app/Services/Care/SpecialtyShellService.php b/app/Services/Care/SpecialtyShellService.php
index 226fb9e..bc79c54 100644
--- a/app/Services/Care/SpecialtyShellService.php
+++ b/app/Services/Care/SpecialtyShellService.php
@@ -270,13 +270,13 @@ class SpecialtyShellService
         ) {
             $code = (string) ($stage['code'] ?? '');
 
-            if ($moduleKey === 'dentistry' && $visitIds->isNotEmpty()) {
+            if (in_array($moduleKey, ['dentistry', 'emergency'], true) && $visitIds->isNotEmpty()) {
                 $count = Visit::owned($ownerRef)
                     ->where('organization_id', $organization->id)
                     ->whereIn('id', $visitIds)
                     ->where('specialty_stage', $code)
                     ->when(
-                        $code !== 'completed',
+                        ! in_array($code, ['completed', 'disposition'], true),
                         fn ($q) => $q->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS]),
                     )
                     ->count();
diff --git a/app/Services/Care/SpecialtyVisitStageService.php b/app/Services/Care/SpecialtyVisitStageService.php
index d36264e..05ed4e1 100644
--- a/app/Services/Care/SpecialtyVisitStageService.php
+++ b/app/Services/Care/SpecialtyVisitStageService.php
@@ -7,6 +7,7 @@ use App\Models\CareQueueTicket;
 use App\Models\Organization;
 use App\Models\Visit;
 use App\Services\Care\AuditLogger;
+use App\Services\Care\Emergency\EmergencyWorkflowService;
 
 /**
  * Persist specialty visit stages (dentistry chair → recovery) and re-route queue tickets.
@@ -79,8 +80,16 @@ class SpecialtyVisitStageService
 
     public function stageOnConsultationStart(string $moduleKey): ?string
     {
+        if ($moduleKey === 'emergency') {
+            $stages = $this->allowedStages($moduleKey);
+
+            return in_array(EmergencyWorkflowService::STAGE_TREATMENT, $stages, true)
+                ? EmergencyWorkflowService::STAGE_TREATMENT
+                : ($stages[1] ?? ($stages[0] ?? null));
+        }
+
         $stages = $this->allowedStages($moduleKey);
-        foreach (['chair', 'in_care', 'exam', 'assessment'] as $preferred) {
+        foreach (['chair', 'in_care', 'exam', 'assessment', 'treatment'] as $preferred) {
             if (in_array($preferred, $stages, true)) {
                 return $preferred;
             }
diff --git a/config/care_specialty_clinical.php b/config/care_specialty_clinical.php
index 96db63e..158a03d 100644
--- a/config/care_specialty_clinical.php
+++ b/config/care_specialty_clinical.php
@@ -14,6 +14,8 @@ return [
         'emergency' => [
             'triage' => 'triage',
             'clinical_notes' => 'clinical_note',
+            'observation' => 'observation',
+            'disposition' => 'disposition',
         ],
         'blood_bank' => [
             'requests' => 'blood_request',
@@ -121,6 +123,24 @@ return [
                 ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'rows' => 3],
                 ['name' => 'procedures', 'label' => 'Procedures performed', 'type' => 'textarea', 'rows' => 2],
             ],
+            'observation' => [
+                ['name' => 'bed_label', 'label' => 'Bed / bay label', 'type' => 'text'],
+                ['name' => 'started_at', 'label' => 'Observation started', 'type' => 'text'],
+                ['name' => 'hours', 'label' => 'Hours observed', 'type' => 'number'],
+                ['name' => 'monitoring_plan', 'label' => 'Monitoring plan', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'progress', 'label' => 'Progress notes', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'ready_for_disposition', 'label' => 'Ready for disposition', 'type' => 'boolean'],
+            ],
+            'disposition' => [
+                ['name' => 'disposition', 'label' => 'Final disposition', 'type' => 'select', 'required' => true, 'options' => ['Discharge home', 'Admit to ward', 'Admit to ICU', 'Transfer to facility', 'Left against advice', 'Died', 'Absconded']],
+                ['name' => 'condition', 'label' => 'Condition at disposition', 'type' => 'select', 'options' => ['Stable', 'Improving', 'Unstable', 'Critical', 'Deceased']],
+                ['name' => 'destination', 'label' => 'Destination (ward / facility)', 'type' => 'text'],
+                ['name' => 'diagnosis', 'label' => 'Discharge / transfer diagnosis', 'type' => 'text', 'required' => true],
+                ['name' => 'advice', 'label' => 'Advice / follow-up', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'medications', 'label' => 'Medications on discharge', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'time', 'label' => 'Disposition time', 'type' => 'text'],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
+            ],
         ],
         'blood_bank' => [
             'blood_request' => [
diff --git a/config/care_specialty_shell.php b/config/care_specialty_shell.php
index 8eed965..a3774c6 100644
--- a/config/care_specialty_shell.php
+++ b/config/care_specialty_shell.php
@@ -58,12 +58,17 @@ return [
                 ['code' => 'er.triage', 'label' => 'Emergency triage', 'amount_minor' => 0, 'type' => 'consultation'],
                 ['code' => 'er.consultation', 'label' => 'Emergency consultation', 'amount_minor' => 8000, 'type' => 'consultation'],
                 ['code' => 'er.procedure', 'label' => 'Emergency procedure', 'amount_minor' => 15000, 'type' => 'procedure'],
+                ['code' => 'er.resuscitation', 'label' => 'Resuscitation', 'amount_minor' => 25000, 'type' => 'procedure'],
                 ['code' => 'er.observation', 'label' => 'Observation bed (per hour)', 'amount_minor' => 3000, 'type' => 'misc'],
+                ['code' => 'er.transfer', 'label' => 'Transfer coordination', 'amount_minor' => 5000, 'type' => 'misc'],
             ],
             'workspace_tabs' => [
                 'overview' => 'Overview',
                 'triage' => 'Triage',
+                'vitals' => 'Vitals',
                 'clinical_notes' => 'Clinical notes',
+                'observation' => 'Observation',
+                'disposition' => 'Disposition',
                 'orders' => 'Orders',
                 'billing' => 'Billing',
                 'documents' => 'Documents',
diff --git a/resources/views/care/specialty/emergency/print.blade.php b/resources/views/care/specialty/emergency/print.blade.php
new file mode 100644
index 0000000..02755e4
--- /dev/null
+++ b/resources/views/care/specialty/emergency/print.blade.php
@@ -0,0 +1,88 @@
+<!DOCTYPE html>
+<html lang="en">
+<head>
+    <meta charset="utf-8">
+    <title>ED summary · {{ $patient->fullName() }}</title>
+    <style>
+        body { font-family: system-ui, sans-serif; color: #0f172a; margin: 2rem; }
+        h1 { font-size: 1.25rem; margin: 0 0 .25rem; }
+        h2 { font-size: .95rem; margin: 1.25rem 0 .5rem; border-bottom: 1px solid #e2e8f0; padding-bottom: .25rem; }
+        .meta { color: #64748b; font-size: .875rem; }
+        dl { display: grid; grid-template-columns: 10rem 1fr; gap: .35rem .75rem; font-size: .875rem; }
+        dt { color: #64748b; }
+        dd { margin: 0; font-weight: 500; }
+        @media print { .no-print { display: none; } }
+    </style>
+</head>
+<body>
+    <p class="no-print"><a href="{{ route('care.specialty.workspace', ['module' => 'emergency', 'visit' => $visit]) }}">Back</a></p>
+
+    <h1>{{ $patient->fullName() }}</h1>
+    <p class="meta">
+        {{ $patient->patient_number }}
+        · Visit #{{ $visit->id }}
+        · Stage {{ $visit->specialty_stage ?? '—' }}
+        · {{ $visit->checked_in_at?->format('d M Y H:i') ?? '—' }}
+    </p>
+
+    <h2>Triage</h2>
+    @if ($triage)
+        <dl>
+            <dt>Acuity</dt><dd>{{ $triage->payload['acuity'] ?? '—' }}</dd>
+            <dt>Chief complaint</dt><dd>{{ $triage->payload['chief_complaint'] ?? '—' }}</dd>
+            <dt>Mode of arrival</dt><dd>{{ $triage->payload['mode_of_arrival'] ?? '—' }}</dd>
+            <dt>ABC</dt>
+            <dd>
+                A {{ ($triage->payload['airway_ok'] ?? true) ? 'OK' : 'Compromised' }}
+                · B {{ ($triage->payload['breathing_ok'] ?? true) ? 'OK' : 'Compromised' }}
+                · C {{ ($triage->payload['circulation_ok'] ?? true) ? 'OK' : 'Compromised' }}
+            </dd>
+            <dt>GCS / Pain</dt><dd>{{ $triage->payload['gcs'] ?? '—' }} / {{ $triage->payload['pain_score'] ?? '—' }}</dd>
+            <dt>Notes</dt><dd>{{ $triage->payload['notes'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No triage recorded.</p>
+    @endif
+
+    <h2>Latest vitals</h2>
+    @if ($latestVitals)
+        <dl>
+            <dt>BP</dt><dd>{{ $latestVitals->bp_systolic ?? '—' }}/{{ $latestVitals->bp_diastolic ?? '—' }}</dd>
+            <dt>Pulse</dt><dd>{{ $latestVitals->pulse ?? '—' }}</dd>
+            <dt>SpO₂</dt><dd>{{ $latestVitals->spo2 ?? '—' }}%</dd>
+            <dt>Temp</dt><dd>{{ $latestVitals->temperature ?? '—' }}</dd>
+            <dt>RR</dt><dd>{{ $latestVitals->respiratory_rate ?? '—' }}</dd>
+            <dt>Recorded</dt><dd>{{ $latestVitals->recorded_at?->format('d M Y H:i') }}</dd>
+        </dl>
+    @else
+        <p class="meta">No vitals recorded.</p>
+    @endif
+
+    <h2>Clinical note</h2>
+    @if ($clinicalNote)
+        <dl>
+            <dt>History</dt><dd>{{ $clinicalNote->payload['history'] ?? '—' }}</dd>
+            <dt>Examination</dt><dd>{{ $clinicalNote->payload['examination'] ?? '—' }}</dd>
+            <dt>Diagnosis</dt><dd>{{ $clinicalNote->payload['working_diagnosis'] ?? '—' }}</dd>
+            <dt>Plan</dt><dd>{{ $clinicalNote->payload['plan'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No clinical note.</p>
+    @endif
+
+    <h2>Disposition</h2>
+    @if ($disposition)
+        <dl>
+            <dt>Disposition</dt><dd>{{ $disposition->payload['disposition'] ?? '—' }}</dd>
+            <dt>Condition</dt><dd>{{ $disposition->payload['condition'] ?? '—' }}</dd>
+            <dt>Destination</dt><dd>{{ $disposition->payload['destination'] ?? '—' }}</dd>
+            <dt>Diagnosis</dt><dd>{{ $disposition->payload['diagnosis'] ?? '—' }}</dd>
+            <dt>Advice</dt><dd>{{ $disposition->payload['advice'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No disposition recorded.</p>
+    @endif
+
+    <script>window.print();</script>
+</body>
+</html>
diff --git a/resources/views/care/specialty/emergency/reports.blade.php b/resources/views/care/specialty/emergency/reports.blade.php
new file mode 100644
index 0000000..67e2ebf
--- /dev/null
+++ b/resources/views/care/specialty/emergency/reports.blade.php
@@ -0,0 +1,88 @@
+<x-app-layout title="Emergency reports">
+    <div class="space-y-6">
+        <div class="flex flex-wrap items-center justify-between gap-3">
+            <div>
+                <h1 class="text-xl font-semibold text-slate-900">Emergency reports</h1>
+                <p class="mt-1 text-sm text-slate-500">Arrivals, acuity mix, dispositions, length of stay, and ED service revenue.</p>
+            </div>
+            <a href="{{ route('care.queue.index') }}" class="text-sm font-medium text-indigo-600">← Back to queue</a>
+        </div>
+
+        <form method="GET" class="flex flex-wrap items-end gap-3 rounded-2xl border border-slate-200 bg-white p-4">
+            <div>
+                <label class="block text-xs font-medium text-slate-600">From</label>
+                <input type="date" name="from" value="{{ $report['from'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">To</label>
+                <input type="date" name="to" value="{{ $report['to'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <button type="submit" class="rounded-xl bg-indigo-600 px-4 py-2 text-sm font-semibold text-white">Apply</button>
+        </form>
+
+        <div class="grid gap-4 sm:grid-cols-4">
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Arrivals today</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['arrivals_today']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Completed today</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['completed_today']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">High-acuity open</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-rose-700">{{ number_format($report['high_acuity_open']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Avg LOS (range)</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">
+                    {{ $report['avg_los_minutes'] !== null ? $report['avg_los_minutes'].' min' : '—' }}
+                </p>
+            </div>
+        </div>
+
+        <div class="grid gap-4 lg:grid-cols-2">
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Acuity distribution</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['acuity_distribution'] as $row)
+                        <li class="flex justify-between gap-3">
+                            <span>{{ $row['acuity'] }}</span>
+                            <span class="tabular-nums text-slate-600">{{ $row['total'] }}</span>
+                        </li>
+                    @empty
+                        <li class="text-slate-500">No triage records in range.</li>
+                    @endforelse
+                </ul>
+            </section>
+
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Dispositions</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['disposition_breakdown'] as $row)
+                        <li class="flex justify-between gap-3">
+                            <span>{{ $row['disposition'] }}</span>
+                            <span class="tabular-nums text-slate-600">{{ $row['total'] }}</span>
+                        </li>
+                    @empty
+                        <li class="text-slate-500">No dispositions in range.</li>
+                    @endforelse
+                </ul>
+            </section>
+        </div>
+
+        <section class="rounded-2xl border border-slate-200 bg-white p-5">
+            <h2 class="text-sm font-semibold text-slate-900">ED service revenue</h2>
+            <ul class="mt-3 space-y-2 text-sm">
+                @forelse ($report['revenue_by_service'] as $row)
+                    <li class="flex justify-between gap-3">
+                        <span>{{ $row->description }} <span class="text-slate-400">×{{ $row->total }}</span></span>
+                        <span class="tabular-nums">{{ $currency }} {{ number_format($row->amount_minor / 100, 2) }}</span>
+                    </li>
+                @empty
+                    <li class="text-slate-500">No ED bill lines in range.</li>
+                @endforelse
+            </ul>
+        </section>
+    </div>
+</x-app-layout>
diff --git a/resources/views/care/specialty/emergency/workspace-disposition.blade.php b/resources/views/care/specialty/emergency/workspace-disposition.blade.php
new file mode 100644
index 0000000..543c0b9
--- /dev/null
+++ b/resources/views/care/specialty/emergency/workspace-disposition.blade.php
@@ -0,0 +1,68 @@
+@php
+    $record = $emergencyDisposition;
+    $payload = old('payload', $record?->payload ?? []);
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Disposition</h3>
+            <p class="mt-0.5 text-xs text-slate-500">Final disposition closes the emergency visit episode.</p>
+        </div>
+        <a href="{{ route('care.specialty.emergency.print', $workspaceVisit) }}" target="_blank" class="text-sm font-medium text-indigo-600">Print summary</a>
+    </div>
+
+    <form method="POST" action="{{ route('care.specialty.emergency.disposition', $workspaceVisit) }}" class="mt-4 space-y-3">
+        @csrf
+        <input type="hidden" name="tab" value="disposition">
+
+        <div class="grid gap-3 sm:grid-cols-2">
+            <div>
+                <label class="block text-xs font-medium text-slate-600">Final disposition</label>
+                <select name="payload[disposition]" required class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                    <option value="">Select…</option>
+                    @foreach (['Discharge home', 'Admit to ward', 'Admit to ICU', 'Transfer to facility', 'Left against advice', 'Died', 'Absconded'] as $opt)
+                        <option value="{{ $opt }}" @selected(($payload['disposition'] ?? '') === $opt)>{{ $opt }}</option>
+                    @endforeach
+                </select>
+                @error('payload.disposition')<p class="mt-1 text-sm text-red-600">{{ $message }}</p>@enderror
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">Condition</label>
+                <select name="payload[condition]" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                    <option value="">Select…</option>
+                    @foreach (['Stable', 'Improving', 'Unstable', 'Critical', 'Deceased'] as $opt)
+                        <option value="{{ $opt }}" @selected(($payload['condition'] ?? '') === $opt)>{{ $opt }}</option>
+                    @endforeach
+                </select>
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">Destination</label>
+                <input type="text" name="payload[destination]" value="{{ $payload['destination'] ?? '' }}" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">Disposition time</label>
+                <input type="text" name="payload[time]" value="{{ $payload['time'] ?? '' }}" placeholder="e.g. 14:30" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div class="sm:col-span-2">
+                <label class="block text-xs font-medium text-slate-600">Diagnosis</label>
+                <input type="text" name="payload[diagnosis]" value="{{ $payload['diagnosis'] ?? '' }}" required class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                @error('payload.diagnosis')<p class="mt-1 text-sm text-red-600">{{ $message }}</p>@enderror
+            </div>
+            <div class="sm:col-span-2">
+                <label class="block text-xs font-medium text-slate-600">Advice / follow-up</label>
+                <textarea name="payload[advice]" rows="3" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $payload['advice'] ?? '' }}</textarea>
+            </div>
+            <div class="sm:col-span-2">
+                <label class="block text-xs font-medium text-slate-600">Medications on discharge</label>
+                <textarea name="payload[medications]" rows="2" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $payload['medications'] ?? '' }}</textarea>
+            </div>
+            <div class="sm:col-span-2">
+                <label class="block text-xs font-medium text-slate-600">Notes</label>
+                <textarea name="payload[notes]" rows="2" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $payload['notes'] ?? '' }}</textarea>
+            </div>
+        </div>
+
+        <button type="submit" class="btn-primary">Save disposition &amp; complete visit</button>
+    </form>
+</section>
diff --git a/resources/views/care/specialty/emergency/workspace-overview.blade.php b/resources/views/care/specialty/emergency/workspace-overview.blade.php
new file mode 100644
index 0000000..da205ed
--- /dev/null
+++ b/resources/views/care/specialty/emergency/workspace-overview.blade.php
@@ -0,0 +1,117 @@
+@php
+    $triage = $emergencyTriage;
+    $payload = $triage?->payload ?? [];
+    $currentStage = $workspaceVisit->specialty_stage;
+    $stageFlow = $emergencyStageFlow ?? [];
+    $latest = $emergencyLatestVitals;
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Emergency overview</h3>
+            <p class="mt-0.5 text-xs text-slate-500">Acuity, stage, ABC flags, and latest vitals for this visit.</p>
+        </div>
+        <div class="flex flex-wrap gap-3 text-sm">
+            <a href="{{ route('care.specialty.emergency.print', $workspaceVisit) }}" target="_blank" class="font-medium text-indigo-600">Print summary</a>
+            <a href="{{ route('care.specialty.emergency.reports') }}" class="font-medium text-indigo-600">ED reports</a>
+        </div>
+    </div>
+
+    <div class="mt-4 grid gap-3 sm:grid-cols-3">
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Acuity</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $payload['acuity'] ?? 'Not triaged' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $payload['chief_complaint'] ?? '—' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">ABC</p>
+            <p class="mt-1 text-sm text-slate-900">
+                A {{ ($payload['airway_ok'] ?? true) ? '✓' : '✗' }}
+                · B {{ ($payload['breathing_ok'] ?? true) ? '✓' : '✗' }}
+                · C {{ ($payload['circulation_ok'] ?? true) ? '✓' : '✗' }}
+            </p>
+            <p class="mt-1 text-xs text-slate-500">Pain {{ $payload['pain_score'] ?? '—' }} · GCS {{ $payload['gcs'] ?? '—' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Latest vitals</p>
+            @if ($latest)
+                <p class="mt-1 text-sm text-slate-900">
+                    BP {{ $latest->bp_systolic ?? '—' }}/{{ $latest->bp_diastolic ?? '—' }}
+                    · P {{ $latest->pulse ?? '—' }}
+                    · SpO₂ {{ $latest->spo2 ?? '—' }}%
+                </p>
+                <p class="mt-1 text-xs text-slate-500">{{ $latest->recorded_at?->format('d M H:i') }}</p>
+            @else
+                <p class="mt-1 text-sm text-slate-500">None recorded</p>
+            @endif
+        </div>
+    </div>
+
+    <div class="mt-4 rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+        <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Visit stage</p>
+        <p class="mt-1 text-sm font-medium text-slate-900">
+            {{ $currentStage ? ucfirst(str_replace('_', ' ', $currentStage)) : 'Not set' }}
+        </p>
+        <div class="mt-3 flex flex-wrap gap-2">
+            @foreach (($emergencyStageCodes ?: ['arrival', 'resus', 'treatment', 'observation', 'disposition']) as $stageCode)
+                <form method="POST" action="{{ route('care.specialty.emergency.stage', $workspaceVisit) }}">
+                    @csrf
+                    <input type="hidden" name="stage" value="{{ $stageCode }}">
+                    <button type="submit"
+                        @class([
+                            'rounded-lg px-2.5 py-1 text-xs font-semibold',
+                            'bg-indigo-600 text-white' => $currentStage === $stageCode,
+                            'border border-slate-200 bg-white text-slate-700 hover:bg-slate-50' => $currentStage !== $stageCode,
+                        ])>
+                        {{ ucfirst(str_replace('_', ' ', $stageCode)) }}
+                    </button>
+                </form>
+            @endforeach
+            @if ($currentStage && isset($stageFlow[$currentStage]) && $stageFlow[$currentStage]['next'] !== $currentStage)
+                <form method="POST" action="{{ route('care.specialty.emergency.stage', $workspaceVisit) }}">
+                    @csrf
+                    <input type="hidden" name="stage" value="{{ $stageFlow[$currentStage]['next'] }}">
+                    <button type="submit" class="rounded-lg bg-emerald-600 px-2.5 py-1 text-xs font-semibold text-white hover:bg-emerald-700">
+                        {{ $stageFlow[$currentStage]['label'] }} →
+                    </button>
+                </form>
+            @endif
+        </div>
+    </div>
+
+    <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+        <div>
+            <dt class="text-slate-500">Mode of arrival</dt>
+            <dd class="font-medium text-slate-900">{{ $payload['mode_of_arrival'] ?? '—' }}</dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Disposition intent</dt>
+            <dd class="font-medium text-slate-900">{{ $payload['disposition_intent'] ?? '—' }}</dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Queue</dt>
+            <dd class="font-medium text-slate-900">
+                {{ $workspaceVisit->appointment?->queue_ticket_number ?? '—' }}
+                @if ($workspaceVisit->appointment?->queue_ticket_status)
+                    <span class="text-slate-500">({{ $workspaceVisit->appointment->queue_ticket_status }})</span>
+                @endif
+            </dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Checked in</dt>
+            <dd class="font-medium text-slate-900">{{ $workspaceVisit->checked_in_at?->format('d M Y H:i') ?? '—' }}</dd>
+        </div>
+    </dl>
+
+    @if (! empty($clinicalAlerts))
+        <div class="mt-4 space-y-1.5 border-t border-slate-100 pt-4">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Alerts</p>
+            @foreach ($clinicalAlerts as $alert)
+                <p class="text-sm {{ ($alert['severity'] ?? '') === 'critical' ? 'text-rose-700' : 'text-amber-800' }}">
+                    {{ $alert['message'] ?? '' }}
+                </p>
+            @endforeach
+        </div>
+    @endif
+</section>
diff --git a/resources/views/care/specialty/emergency/workspace-vitals.blade.php b/resources/views/care/specialty/emergency/workspace-vitals.blade.php
new file mode 100644
index 0000000..f9617c4
--- /dev/null
+++ b/resources/views/care/specialty/emergency/workspace-vitals.blade.php
@@ -0,0 +1,67 @@
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Vitals</h3>
+            <p class="mt-0.5 text-xs text-slate-500">Record BP, pulse, SpO₂, temperature, and respiratory rate on this ED visit.</p>
+        </div>
+    </div>
+
+    <form method="POST" action="{{ route('care.specialty.emergency.vitals', $workspaceVisit) }}" class="mt-4 grid gap-3 sm:grid-cols-4">
+        @csrf
+        <div>
+            <label class="block text-xs font-medium text-slate-600">BP systolic</label>
+            <input type="number" name="bp_systolic" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+        </div>
+        <div>
+            <label class="block text-xs font-medium text-slate-600">BP diastolic</label>
+            <input type="number" name="bp_diastolic" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+        </div>
+        <div>
+            <label class="block text-xs font-medium text-slate-600">Pulse</label>
+            <input type="number" name="pulse" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+        </div>
+        <div>
+            <label class="block text-xs font-medium text-slate-600">SpO₂ %</label>
+            <input type="number" name="spo2" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+        </div>
+        <div>
+            <label class="block text-xs font-medium text-slate-600">Temperature °C</label>
+            <input type="number" step="0.1" name="temperature" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+        </div>
+        <div>
+            <label class="block text-xs font-medium text-slate-600">Respiratory rate</label>
+            <input type="number" name="respiratory_rate" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+        </div>
+        <div>
+            <label class="block text-xs font-medium text-slate-600">Weight kg</label>
+            <input type="number" step="0.1" name="weight_kg" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+        </div>
+        <div>
+            <label class="block text-xs font-medium text-slate-600">Height cm</label>
+            <input type="number" step="0.1" name="height_cm" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+        </div>
+        <div class="sm:col-span-4">
+            <button type="submit" class="btn-primary">Save vitals</button>
+        </div>
+    </form>
+
+    <div class="mt-6 border-t border-slate-100 pt-4">
+        <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">History</p>
+        <ul class="mt-2 divide-y divide-slate-100 text-sm">
+            @forelse ($emergencyVitals as $row)
+                <li class="flex flex-wrap justify-between gap-2 py-2">
+                    <span>
+                        BP {{ $row->bp_systolic ?? '—' }}/{{ $row->bp_diastolic ?? '—' }}
+                        · P {{ $row->pulse ?? '—' }}
+                        · SpO₂ {{ $row->spo2 ?? '—' }}%
+                        · T {{ $row->temperature ?? '—' }}
+                        · RR {{ $row->respiratory_rate ?? '—' }}
+                    </span>
+                    <span class="text-slate-500">{{ $row->recorded_at?->format('d M Y H:i') }}</span>
+                </li>
+            @empty
+                <li class="py-3 text-slate-500">No vitals recorded yet.</li>
+            @endforelse
+        </ul>
+    </div>
+</section>
diff --git a/resources/views/care/specialty/partials/actions-menu.blade.php b/resources/views/care/specialty/partials/actions-menu.blade.php
index 7ff41d5..e1c047a 100644
--- a/resources/views/care/specialty/partials/actions-menu.blade.php
+++ b/resources/views/care/specialty/partials/actions-menu.blade.php
@@ -22,14 +22,21 @@
         && $openConsultation->status !== \App\Models\Consultation::STATUS_COMPLETED;
         $chartTab = collect($workspaceTabs ?? [])
             ->keys()
-            ->first(fn ($key) => ! in_array($key, ['overview', 'timeline', 'plan', 'treat', 'notes', 'imaging', 'orders', 'billing', 'documents', 'perio', 'lab', 'recalls'], true))
-            ?: 'odontogram';
-    $stageFlow = [
-        'waiting' => ['next' => 'chair', 'label' => 'Seat at chair'],
-        'chair' => ['next' => 'procedure', 'label' => 'Start procedure'],
-        'procedure' => ['next' => 'recovery', 'label' => 'Move to recovery'],
-        'recovery' => ['next' => 'completed', 'label' => 'Complete visit'],
-    ];
+            ->first(fn ($key) => ! in_array($key, ['overview', 'timeline', 'plan', 'treat', 'notes', 'imaging', 'orders', 'billing', 'documents', 'perio', 'lab', 'recalls', 'vitals', 'disposition', 'observation'], true))
+            ?: ($moduleKey === 'emergency' ? 'triage' : 'odontogram');
+    $stageFlow = $moduleKey === 'emergency'
+        ? ($emergencyStageFlow ?? [
+            'arrival' => ['next' => 'treatment', 'label' => 'Move to treatment'],
+            'resus' => ['next' => 'treatment', 'label' => 'Move to treatment bay'],
+            'treatment' => ['next' => 'observation', 'label' => 'Move to observation'],
+            'observation' => ['next' => 'disposition', 'label' => 'Ready for disposition'],
+        ])
+        : [
+            'waiting' => ['next' => 'chair', 'label' => 'Seat at chair'],
+            'chair' => ['next' => 'procedure', 'label' => 'Start procedure'],
+            'procedure' => ['next' => 'recovery', 'label' => 'Move to recovery'],
+            'recovery' => ['next' => 'completed', 'label' => 'Complete visit'],
+        ];
     $currentStage = $workspaceVisit?->specialty_stage;
 @endphp
 
@@ -63,6 +70,18 @@
             <input type="hidden" name="stage" value="chair">
             <button type="submit" class="{{ $btnAccent }}">Seat at chair</button>
         </form>
+    @elseif ($moduleKey === 'emergency' && $currentStage && isset($stageFlow[$currentStage]) && ($stageFlow[$currentStage]['next'] ?? null) !== $currentStage)
+        <form method="POST" action="{{ route('care.specialty.emergency.stage', $workspaceVisit) }}" class="w-full" @click.stop>
+            @csrf
+            <input type="hidden" name="stage" value="{{ $stageFlow[$currentStage]['next'] }}">
+            <button type="submit" class="{{ $btnAccent }}">{{ $stageFlow[$currentStage]['label'] }}</button>
+        </form>
+    @elseif ($moduleKey === 'emergency' && ! $currentStage)
+        <form method="POST" action="{{ route('care.specialty.emergency.stage', $workspaceVisit) }}" class="w-full" @click.stop>
+            @csrf
+            <input type="hidden" name="stage" value="arrival">
+            <button type="submit" class="{{ $btnAccent }}">Start triage</button>
+        </form>
     @endif
 
     @if ($canCompleteConsultation)
diff --git a/resources/views/care/specialty/sections/workspace.blade.php b/resources/views/care/specialty/sections/workspace.blade.php
index fc8587f..26f9dfc 100644
--- a/resources/views/care/specialty/sections/workspace.blade.php
+++ b/resources/views/care/specialty/sections/workspace.blade.php
@@ -38,6 +38,8 @@
             @include('care.partials.patient-timeline', ['events' => $timeline ?? []])
         @elseif ($moduleKey === 'dentistry' && in_array($activeTab, ['odontogram', 'plan', 'treat', 'notes', 'imaging', 'overview', 'perio', 'lab', 'recalls'], true))
             @include('care.specialty.dentistry.workspace-'.$activeTab)
+        @elseif ($moduleKey === 'emergency' && in_array($activeTab, ['overview', 'vitals', 'disposition'], true))
+            @include('care.specialty.emergency.workspace-'.$activeTab)
         @elseif ($activeTab === 'billing')
             <section class="rounded-2xl border border-slate-200 bg-white p-5">
                 <h3 class="text-sm font-semibold text-slate-900">Add specialty service</h3>
diff --git a/routes/web.php b/routes/web.php
index 4bff339..dc92225 100644
--- a/routes/web.php
+++ b/routes/web.php
@@ -36,6 +36,7 @@ use App\Http\Controllers\Care\SettingsController;
 use App\Http\Controllers\Care\SettingsGpPricingController;
 use App\Http\Controllers\Care\SettingsModulesController;
 use App\Http\Controllers\Care\DentistryWorkspaceController;
+use App\Http\Controllers\Care\EmergencyWorkspaceController;
 use App\Http\Controllers\Care\SpecialtyModuleController;
 use App\Http\Controllers\Care\VisitWorkflowController;
 use App\Http\Controllers\NotificationController;
@@ -114,6 +115,7 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
             Route::get('/specialty/{module}/history', [SpecialtyModuleController::class, 'history'])->name('care.specialty.history');
             Route::get('/specialty/{module}/billing', [SpecialtyModuleController::class, 'billing'])->name('care.specialty.billing');
             Route::get('/specialty/dentistry/reports', [DentistryWorkspaceController::class, 'reports'])->name('care.specialty.dentistry.reports');
+            Route::get('/specialty/emergency/reports', [EmergencyWorkspaceController::class, 'reports'])->name('care.specialty.emergency.reports');
             Route::get('/specialty/{module}/workspace/{visit?}', [SpecialtyModuleController::class, 'workspace'])->name('care.specialty.workspace');
             Route::post('/specialty/{module}/workspace/{visit}/clinical', [SpecialtyModuleController::class, 'saveClinical'])->name('care.specialty.clinical.save');
             Route::post('/specialty/{module}/workspace/{visit}/documents', [SpecialtyModuleController::class, 'uploadDocument'])->name('care.specialty.documents.upload');
@@ -139,6 +141,10 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
             Route::post('/specialty/dentistry/workspace/{visit}/recalls/{recall}/complete', [DentistryWorkspaceController::class, 'completeRecall'])->name('care.specialty.dentistry.recalls.complete');
             Route::post('/specialty/dentistry/workspace/{visit}/recalls/{recall}/cancel', [DentistryWorkspaceController::class, 'cancelRecall'])->name('care.specialty.dentistry.recalls.cancel');
             Route::get('/specialty/dentistry/workspace/{visit}/print', [DentistryWorkspaceController::class, 'printChart'])->name('care.specialty.dentistry.print');
+            Route::post('/specialty/emergency/workspace/{visit}/stage', [EmergencyWorkspaceController::class, 'setStage'])->name('care.specialty.emergency.stage');
+            Route::post('/specialty/emergency/workspace/{visit}/vitals', [EmergencyWorkspaceController::class, 'saveVitals'])->name('care.specialty.emergency.vitals');
+            Route::post('/specialty/emergency/workspace/{visit}/disposition', [EmergencyWorkspaceController::class, 'saveDisposition'])->name('care.specialty.emergency.disposition');
+            Route::get('/specialty/emergency/workspace/{visit}/print', [EmergencyWorkspaceController::class, 'printSummary'])->name('care.specialty.emergency.print');
             Route::get('/specialty/{module}', [SpecialtyModuleController::class, 'show'])->name('care.specialty.show');
             Route::post('/specialty/{module}/call-next', [SpecialtyModuleController::class, 'callNext'])->name('care.specialty.call-next');
 
diff --git a/tests/Feature/CareEmergencySuiteTest.php b/tests/Feature/CareEmergencySuiteTest.php
new file mode 100644
index 0000000..de98910
--- /dev/null
+++ b/tests/Feature/CareEmergencySuiteTest.php
@@ -0,0 +1,241 @@
+<?php
+
+namespace Tests\Feature;
+
+use App\Http\Middleware\EnsurePlatformSession;
+use App\Models\Appointment;
+use App\Models\Branch;
+use App\Models\Department;
+use App\Models\Member;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\User;
+use App\Models\Visit;
+use App\Models\VitalSign;
+use App\Services\Care\SpecialtyModuleService;
+use Illuminate\Foundation\Testing\RefreshDatabase;
+use Tests\TestCase;
+
+class CareEmergencySuiteTest extends TestCase
+{
+    use RefreshDatabase;
+
+    protected User $owner;
+
+    protected Organization $organization;
+
+    protected Branch $branch;
+
+    protected Patient $patient;
+
+    protected Visit $visit;
+
+    protected function setUp(): void
+    {
+        parent::setUp();
+        $this->withoutMiddleware(EnsurePlatformSession::class);
+
+        $this->owner = User::create([
+            'public_id' => 'er-owner',
+            'name' => 'Owner',
+            'email' => 'er-owner@example.com',
+        ]);
+
+        $this->organization = Organization::create([
+            'owner_ref' => $this->owner->public_id,
+            'name' => 'Emergency Clinic',
+            'slug' => 'emergency-clinic',
+            'settings' => [
+                'onboarded' => true,
+                'facility_type' => 'clinic',
+                'plan' => 'pro',
+                'plan_expires_at' => now()->addMonth()->toIso8601String(),
+                'queue_integration_enabled' => true,
+            ],
+        ]);
+
+        Member::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'user_ref' => $this->owner->public_id,
+            'role' => 'hospital_admin',
+            'branch_id' => null,
+        ]);
+
+        $this->branch = Branch::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'name' => 'Main',
+            'is_active' => true,
+        ]);
+
+        app(SpecialtyModuleService::class)->activate(
+            $this->organization,
+            $this->owner->public_id,
+            'emergency',
+        );
+
+        $department = Department::query()
+            ->where('branch_id', $this->branch->id)
+            ->where('type', 'emergency')
+            ->firstOrFail();
+
+        $this->patient = Patient::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-ER-SUITE',
+            'first_name' => 'Kwame',
+            'last_name' => 'Boateng',
+            'gender' => 'male',
+            'date_of_birth' => '1988-01-01',
+        ]);
+
+        $this->visit = Visit::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'status' => Visit::STATUS_IN_PROGRESS,
+            'checked_in_at' => now(),
+            'specialty_stage' => 'arrival',
+        ]);
+
+        Appointment::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'department_id' => $department->id,
+            'visit_id' => $this->visit->id,
+            'type' => Appointment::TYPE_WALK_IN,
+            'status' => Appointment::STATUS_IN_CONSULTATION,
+            'scheduled_at' => now(),
+            'waiting_at' => now(),
+            'checked_in_at' => now(),
+            'started_at' => now(),
+        ]);
+    }
+
+    public function test_overview_and_vitals_tabs_render(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'emergency',
+                'visit' => $this->visit,
+                'tab' => 'overview',
+            ]))
+            ->assertOk()
+            ->assertSee('Emergency overview')
+            ->assertSee('Visit stage')
+            ->assertSee('ED reports');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'emergency',
+                'visit' => $this->visit,
+                'tab' => 'vitals',
+            ]))
+            ->assertOk()
+            ->assertSee('Save vitals');
+    }
+
+    public function test_triage_sets_stage_and_alerts(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.clinical.save', [
+                'module' => 'emergency',
+                'visit' => $this->visit,
+            ]), [
+                'tab' => 'triage',
+                'payload' => [
+                    'acuity' => '1 - Resuscitation',
+                    'chief_complaint' => 'Chest pain',
+                    'airway_ok' => '1',
+                    'breathing_ok' => '0',
+                    'circulation_ok' => '1',
+                    'pain_score' => 9,
+                    'disposition_intent' => 'Resus',
+                ],
+            ])
+            ->assertRedirect();
+
+        $this->assertSame('resus', $this->visit->fresh()->specialty_stage);
+
+        $record = SpecialtyClinicalRecord::query()
+            ->where('visit_id', $this->visit->id)
+            ->where('record_type', 'triage')
+            ->firstOrFail();
+
+        $codes = collect($record->alerts)->pluck('code')->all();
+        $this->assertContains('er.high_acuity', $codes);
+        $this->assertContains('er.abc_compromise', $codes);
+        $this->assertContains('er.severe_pain', $codes);
+    }
+
+    public function test_stage_advance_and_vitals_and_disposition(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.emergency.stage', $this->visit), [
+                'stage' => 'treatment',
+            ])
+            ->assertRedirect();
+
+        $this->assertSame('treatment', $this->visit->fresh()->specialty_stage);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.emergency.vitals', $this->visit), [
+                'bp_systolic' => 120,
+                'bp_diastolic' => 80,
+                'pulse' => 88,
+                'spo2' => 98,
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'emergency',
+                'visit' => $this->visit,
+                'tab' => 'vitals',
+            ]));
+
+        $this->assertDatabaseHas('care_vital_signs', [
+            'bp_systolic' => 120,
+            'pulse' => 88,
+        ]);
+        $this->assertTrue(VitalSign::query()->where('bp_systolic', 120)->exists());
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.emergency.disposition', $this->visit), [
+                'tab' => 'disposition',
+                'payload' => [
+                    'disposition' => 'Discharge home',
+                    'condition' => 'Stable',
+                    'diagnosis' => 'Musculoskeletal chest wall pain',
+                    'advice' => 'Return if worsens',
+                ],
+            ])
+            ->assertRedirect();
+
+        $this->assertSame('disposition', $this->visit->fresh()->specialty_stage);
+        $this->assertSame(Visit::STATUS_COMPLETED, $this->visit->fresh()->status);
+        $this->assertDatabaseHas('care_specialty_clinical_records', [
+            'visit_id' => $this->visit->id,
+            'record_type' => 'disposition',
+            'status' => SpecialtyClinicalRecord::STATUS_COMPLETED,
+        ]);
+    }
+
+    public function test_reports_and_print(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.emergency.reports'))
+            ->assertOk()
+            ->assertSee('Emergency reports')
+            ->assertSee('Arrivals today');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.emergency.print', $this->visit))
+            ->assertOk()
+            ->assertSee('ED summary')
+            ->assertSee($this->patient->fullName());
+    }
+}