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Volume of intensive care unit patients in the emergency department: Clinical experience in a training and research hospital

Murat Guzel, Sener Cindoruk, Mehmet Tevfik Demir, Mehmet Yorgun, Erdinc Yavuz, Emre Ozgen, Murat Yucel, Ahmet Baydin.




Abstract

There is an increasing tendency for critically ill patients to present to emergency departments (EDs). In this study, it was aimed to assess patients who presented to the ED and admitted to the intensive care unit (ICU) and to identify waiting times in the ED. This retrospective study was conducted by reviewing data from 4904 patients (aged >18 years) who presented to the ED for whom the decision was made for hospitalization in the ICU between January 1st, 2016, and December 31st, 2017. Waiting time in the ED, demographic data, and length of ICU stay were reviewed for 3572 patients who were admitted to ICUs from the ED. The total number of patients who presented to the ED between January 1st, 2016, and December 31st, 2017 was 200,603. Among these patients, the ICU admission rate was 2.4%. Of 4904 patients who presented to the ED and the decision was made for ICU admission, 1332 patients were transferred to other facilities. When these patients were excluded, the ICU admission rate was found as 1.8% in our facility. When time to ICU admission from the ED was assessed, it was found that the shortest time recorded for admission from the ED to the burns unit was 48 minutes. The second shortest waiting time (148 min) was seen in patients admitted to the coronary intensive care unit. The mean waiting time of ICU patients in the ED was 282 min. The increase in the patients who have been decided to hospitalization in the ICU in the ED remains an important problem that should be managed in the ED crowd. Long waiting times for ICU patients in the ED make the already existing crowd more complicated.

Key words: Emergency department, intensive care, emergency department crowding






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