Recommendations for acceptable emergency department (ED) length of stay (LOS) vary internationally with = 8 h generally considered acceptable. Protracted ED LOS may place critically ill patients requiring mechanical ventilation at increased risk of adverse events as most EDs are not resourced for longitudinal delivery of critical care. Our objective was to quantify the ED LOS for mechanically ventilated patients (invasive and/or non-invasive ventilation [NIV]) and to explore patient and system level predictors of prolonged ED LOS. Additionally, we aimed to describe delivery and monitoring of ventilation in the ED.
Prospective observational study of ED LOS for all patients receiving mechanical ventilation at four metropolitan EDs in Toronto, Canada over two six-month periods in 2009 and 2010.
We identified 618 mechanically ventilated patients which represented 0.5% (95% CI 0.4%-0.5%) of all ED visits. Of these, 484 (78.3%) received invasive ventilation, 118 (19.1%) received NIV; 16 received both during the ED stay. Median Kaplan-Meier estimated duration of ED stay for all patients was 6.4 h (IQR 2.8-14.6). Patients with trauma diagnoses had a shorter median (IQR) LOS, 2.5 h (1.3-5.1), compared to ventilated patients with non-trauma diagnoses, 8.5 h (3.3-14.0) (p
Notes
Cites: Am J Emerg Med. 2005 May;23(3):336-915915409
Cites: Crit Care Med. 2005 May;33(5):974-815891323
Cites: Med J Aust. 2006 Mar 6;184(5):208-1216515429
Cites: Med J Aust. 2006 Mar 6;184(5):213-616515430
Cites: Crit Care Med. 2006 Apr;34(4):1202-816484927
Cites: Crit Care Med. 2007 Jun;35(6):1477-8317440421
Cites: Ann Emerg Med. 2007 Nov;50(5):510-617913298
Cites: Am J Respir Crit Care Med. 2008 Jan 15;177(2):170-717962636
Cites: J Trauma. 2008 Feb;64(2):341-718301196
Cites: Emerg Med Australas. 2008 Jun;20(3):260-618062783
Cites: Int Emerg Nurs. 2008 Jul;16(3):200-618627806