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4 results

  • 4 - The Boarding ICU Patient in the Emergency Department

  • from Section 1 - General Critical Care
  • Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
  • Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 39-46

  • Summary

    Critical illness should be viewed as a continuum from prehospital development of disease, through emergency department (ED) presentation to intensive care unit (ICU) admission to post-ICU care and ultimately to hospital discharge. Over two million patients are admitted to ICUs from EDs each year in the US. Critical care visits increased by 80% between 2006 and 2014. More than 50% of ICU admissions remain in the ED in excess of 6 hours. ICU patients who remain in the ED have been shown to have worse outcomes.

  • 5 - The boarding ICU patient in the emergency department

  • from Section 1 - General critical care
  • Edited by Kaushal Shah, Jarone Lee, Kamal Medlej, American University of Beirut, Scott D. Weingart
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    05 November 2013
    Print publication:
    24 October 2013, pp 35-40

  • Summary

    This chapter discusses the management of intensive care unit (ICU) patient in the emergency department. Frequent reassessment of ICU boarders is essential. Since mortality starts to increase at about 6 hours, it is reasonable to completely reassess an ICU boarder every 2-4 hours. Assessments should focus on fundamentals of care and disease-specific goals. Volume status is a critical component of resuscitation and management. Accurate "Ins and Outs" are frequently poorly recorded in ICU boarders. This can be remedied by asking the nurses to never take down an empty IV bag, and to number each IV bag with a permanent marker prior to administration. The ICU is completely responsible for patient care, orders, and management. The emergency physician is available for emergent interventions and acute deterioration while the patient is in the emergency department (ED). Shared responsibility of care is often dictated by a consensus interdepartmental policy.