Critical care in the emergency department: It's critical to know what's going on!

摘要

The ICU is considered the ultimate area for care of the critically ill. Intensivists focus on ICU occupancy (1), length of stay, manpower, care models, bundles, and mortality. In contrast, intensivists do not commonly consider the nuances of critical care delivery in the emergency department (ED), a primary source of ICU patients. ED clinicians, however, have sought for many years to increase their skill sets in critical care and contribute to the field by participating in critical care medicine (CCM) fellowship training programs (2, 3) and sepsis research (4, 5). Despite ED involvement in CCM, we are left with several important questions in regard to ED care of the critically ill. How do we nationally identify critically ill ED patients? What proportion of ED patients are critically ill? Are the critically ill ED patients expediently transferred to the ICU? And, have these patterns changed over the last decade?