Spending the Night in the ED Might Kill You
Ғылым және технология
A new study suggests long stays in the Emergency Department, instead of being sent to the regular hospital, are associated with higher mortality.
As a consulting nephrologist, I go all over the hospital. Medicine floors, surgical floors, the ICU - I’ve even done consults in the operating room before. And, more and more, I do consults in the Emergency Department.
The reason I am doing more and more consults in the Emergency Department is not because the ED docs are getting gun shy with creatinine increases - it’s because patients are staying for extended periods in the Emergency Department despite being formally admitted to the hospital - a phenomenon known as boarding - because there are simply not enough beds. You know the scene if you have ever been to a busy hospital - the ED is full to breaking, with patients on stretchers in hallways, it can often feel more like a warzone than a place for healing.
This is a huge problem.
The Joint Commission specifies that admitted patients should spend no more than four hours in the ED waiting for a bed in the hospital.
That is, based on what I’ve seen, hugely ambitious. But I should point out that I work in a hospital that runs near capacity all the time, and that studies - from some of my Yale Colleagues actually - have shown that once hospital capacity exceeds 85%, boarding rates skyrocket.
And I want to dig into some of the causes of extended boarding, and some solutions, but before that, I should probably prove to you that this really matters, and for that we are going to dig into a new study which suggests that ED boarding kills.
Click here to subscribe: kzread.info...
Get more medical news analysis at www.methodsman.com or www.medscape.com
#medicine #emergencyroom #science
Пікірлер: 2
I have a good anecdote of a someone who died waiting in emergency. They were an Child Pugh C patient admitted under gastro who presented with hyponatraemia. There were a job on our electronic noticeboard to do a blood gas to check the the sodium when they come onto the ward. Come 3AM that didn't happen and my registrar told me to do it in ED. They looked pretty awful and while the sodium was appropriately corrected their lactate was rising. It seems later that night they arrested and that was that. It was probably a bit of inaction on our part not to do it sooner but you can only do so much with an electronic handover.
I'd guess people get stressed and therefore mortality rises. We always pretend like we are so different from animals dying from fear but we are not. In the ED there are more people we dont know, there's no privacy, no protection in a time we feel we are weak. You d stress out every animal in this Situation, some would die why shouldnt we? Especially people who have trauma, autism etc...