| Critical care in the emergency department: a time-based study. | |
| | |
MedLine Citation:
|
PMID: 8319477 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: Emergency departments serve many functions in the current U.S. healthcare system, including initial management of patients with critical illnesses and primary care for a growing proportion of the population. Overcrowding of emergency departments is a growing problem. Delays in admitting patients to inpatient units have been reported as a contributing factor to overcrowding. To date, the effect of the critically ill patients on the emergency department has not been fully described. It was the purpose of this study to examine the incidence of critical illness in the emergency department and its total burden as reflected in emergency department length of stay. DESIGN: Prospective, cohort study in 17,900 emergency department patients. SETTING: Single, not-for-profit teaching hospital. PATIENTS: All patients admitted to the emergency department during the period of April 1, 1991 to March 31, 1992. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Date and time of arrival in the emergency department and time of discharge, death, or admission to an inpatient unit were recorded. Patients admitted to intensive care units/special care units from the emergency department were defined as critically ill. All other patients were classified as noncritically ill. Emergency department length of stay was calculated as the time from arrival in the emergency department until discharge, death, or admission to an inpatient unit. Differences in length of stay were determined using Kruskal-Wallis analysis by ranks. The study population totaled 17,900 patients: 8.5% (n = 1,527) critically ill patients, 61.1% (n = 10,930) discharged patients, and 30.4% (n = 5,443) noncritically ill admitted patients. Mean emergency department length of stay for the critically ill patients was 145.3 +/- 89.6 mins (maximum length of stay, 655 mins), and for the noncritically ill patients, mean stay was 153.1 +/- 91.9 mins (maximum length of stay, 781 mins) (p < .0003). During the study period, 154 patient-days of emergency department critical care were provided. CONCLUSIONS: Critically ill patients constitute an important proportion of emergency department practice and may remain in the emergency department for significant periods of time. Solutions to emergency department overcrowding may include alternatives for continuing management of critically ill patients. Given the realities of emergency department practice, emergency medicine practitioners should receive training in the continuing management of critically ill patients. |
| | |
Authors:
|
R E Fromm; L R Gibbs; W G McCallum; C Niziol; J C Babcock; A C Gueler; R L Levine |
Related Documents
:
|
109057 - The septic burned patient: a model for studying the role of complement and immunoglobul... 8169507 - Burning sensation in the throat--should it be named caloripharyngeus? 14726747 - Burn injury in patients with early-onset neurological impairments: 2002 aba paper. 22293277 - Inverse correlation between stroke and urinary 3-hydroxypropyl mercapturic acid, an acr... 7738747 - Intestinal neuronal dysplasia is a possible cause of persistent bowel symptoms after pu... 9921987 - Is there a diagnostic role for bone scanning of patients with a high pretest probabilit... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Critical care medicine Volume: 21 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 1993 Jul |
Date Detail:
|
Created Date: 1993-08-03 Completed Date: 1993-08-03 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 970-6 Citation Subset: AIM; IM |
Affiliation:
|
Department of Emergency Services, Methodist Hospital, Houston, TX. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Cohort Studies Critical Care* Emergency Service, Hospital / utilization* Humans Length of Stay Patient Admission Prospective Studies Time Factors |
| Comments/Corrections | |
Comment In:
|
Crit Care Med. 1994 May;22(5):896-8
[PMID:
8181304
]
Crit Care Med. 1993 Jul;21(7):952-3 [PMID: 8031334 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Intratracheal perfluorocarbon administration combined with mechanical ventilation in experimental re...
Next Document: Hemodynamic and oxygen transport responses in survivors and nonsurvivors of high-risk surgery.