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Emergency team calls for critically ill non-trauma patients in the emergency department: an observational study

BACKGROUND: Handling critically ill patients is a complex task for Emergency Department (ED) personnel. Initial treatment is of major importance and requires adequately experienced ED doctors to initiate and decide for the right medical or surgical treatment. Our aim was, with regard to clinical pre...

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Autores principales: Jensen, Søren Marker, Do, Hien Quoc, Rasmussen, Søren W., Rasmussen, Lars S., Schmidt, Thomas Andersen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4594893/
https://www.ncbi.nlm.nih.gov/pubmed/26444406
http://dx.doi.org/10.1186/s13049-015-0159-2
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author Jensen, Søren Marker
Do, Hien Quoc
Rasmussen, Søren W.
Rasmussen, Lars S.
Schmidt, Thomas Andersen
author_facet Jensen, Søren Marker
Do, Hien Quoc
Rasmussen, Søren W.
Rasmussen, Lars S.
Schmidt, Thomas Andersen
author_sort Jensen, Søren Marker
collection PubMed
description BACKGROUND: Handling critically ill patients is a complex task for Emergency Department (ED) personnel. Initial treatment is of major importance and requires adequately experienced ED doctors to initiate and decide for the right medical or surgical treatment. Our aim was, with regard to clinical presentation, management and mortality to describe adult non-trauma patients that upon ED arrival elicited emergency team calls. METHODS: An observational study of adult patients (≥18 years) admitted to a regional ED with conditions that elicited acute team activation and additional emergency team consultation calls for non-ED specialist physicians. Emergency team calls were two-tiered with ‘orange’ and ‘red’ calls. Additionally, intensive care unit (ICU) admission charts were reviewed to identify the total number of adult non-trauma and non-cardiac arrest patients admitted to the ICU from the ED during the study period. RESULTS: A total of 109 emergency team calls were triggered (79 orange and 30 red), comprising 66 (60.6 %) men and 43 women, with a median age of 64 years. Patients presented with: 4 Airway, 27 Breathing, 41 Circulation, 31 Disability, 2 Exposure and 4 Other problems. Overall, 58/109 (53.2 %) patients were admitted to the ICU, while 20/109 (18.3 %) patients were deemed ineligible for ICU admission. 30-day mortality was 34/109 (31.2 %), and circulatory problems were the most frequent cause of death (61.8 %, p = 0.02). Patients who died were significantly older than those who survived (p = 0.004). Additionally, 115 adult patients were admitted to the ICU directly from the ED without eliciting an emergency team call during the study period. These patients mainly comprised patients who were intoxicated, were unconscious or had respiratory failure. CONCLUSION: The majority of emergency team call patients presented with circulatory, disability and breathing problems. Half of the patients were admitted to the ICU, although a high rate of patients was deemed ineligible for ICU admission. 30-day mortality was considerable and circulatory related illnesses were associated with increased short-term mortality. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13049-015-0159-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-45948932015-10-07 Emergency team calls for critically ill non-trauma patients in the emergency department: an observational study Jensen, Søren Marker Do, Hien Quoc Rasmussen, Søren W. Rasmussen, Lars S. Schmidt, Thomas Andersen Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: Handling critically ill patients is a complex task for Emergency Department (ED) personnel. Initial treatment is of major importance and requires adequately experienced ED doctors to initiate and decide for the right medical or surgical treatment. Our aim was, with regard to clinical presentation, management and mortality to describe adult non-trauma patients that upon ED arrival elicited emergency team calls. METHODS: An observational study of adult patients (≥18 years) admitted to a regional ED with conditions that elicited acute team activation and additional emergency team consultation calls for non-ED specialist physicians. Emergency team calls were two-tiered with ‘orange’ and ‘red’ calls. Additionally, intensive care unit (ICU) admission charts were reviewed to identify the total number of adult non-trauma and non-cardiac arrest patients admitted to the ICU from the ED during the study period. RESULTS: A total of 109 emergency team calls were triggered (79 orange and 30 red), comprising 66 (60.6 %) men and 43 women, with a median age of 64 years. Patients presented with: 4 Airway, 27 Breathing, 41 Circulation, 31 Disability, 2 Exposure and 4 Other problems. Overall, 58/109 (53.2 %) patients were admitted to the ICU, while 20/109 (18.3 %) patients were deemed ineligible for ICU admission. 30-day mortality was 34/109 (31.2 %), and circulatory problems were the most frequent cause of death (61.8 %, p = 0.02). Patients who died were significantly older than those who survived (p = 0.004). Additionally, 115 adult patients were admitted to the ICU directly from the ED without eliciting an emergency team call during the study period. These patients mainly comprised patients who were intoxicated, were unconscious or had respiratory failure. CONCLUSION: The majority of emergency team call patients presented with circulatory, disability and breathing problems. Half of the patients were admitted to the ICU, although a high rate of patients was deemed ineligible for ICU admission. 30-day mortality was considerable and circulatory related illnesses were associated with increased short-term mortality. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13049-015-0159-2) contains supplementary material, which is available to authorized users. BioMed Central 2015-10-06 /pmc/articles/PMC4594893/ /pubmed/26444406 http://dx.doi.org/10.1186/s13049-015-0159-2 Text en © Jensen et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research
Jensen, Søren Marker
Do, Hien Quoc
Rasmussen, Søren W.
Rasmussen, Lars S.
Schmidt, Thomas Andersen
Emergency team calls for critically ill non-trauma patients in the emergency department: an observational study
title Emergency team calls for critically ill non-trauma patients in the emergency department: an observational study
title_full Emergency team calls for critically ill non-trauma patients in the emergency department: an observational study
title_fullStr Emergency team calls for critically ill non-trauma patients in the emergency department: an observational study
title_full_unstemmed Emergency team calls for critically ill non-trauma patients in the emergency department: an observational study
title_short Emergency team calls for critically ill non-trauma patients in the emergency department: an observational study
title_sort emergency team calls for critically ill non-trauma patients in the emergency department: an observational study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4594893/
https://www.ncbi.nlm.nih.gov/pubmed/26444406
http://dx.doi.org/10.1186/s13049-015-0159-2
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