Journal of the American College of Emergency Physicians open
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J Am Coll Emerg Physicians Open · Aug 2020
Characteristics of adult out-of-hospital cardiac arrest in the National Emergency Medical Services Information System.
The national incidence and characteristics of out-of-hospital cardiac arrest in the United States is unclear. We sought to describe the national characteristics of adult out-of-hospital cardiac arrest reported in the National Emergency Medical Services Information System (NEMSIS). ⋯ Using information available in the 2016 NEMSIS data, we estimate that there were over 570,000 reported adult out-of-hospital cardiac arrests in the United States. These results highlight the challenges of characterizing the epidemiology of adult out-of-hospital cardiac arrest in the United States.
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J Am Coll Emerg Physicians Open · Aug 2020
Boarding of critically Ill patients in the emergency department.
Emergency department boarding is the practice of caring for admitted patients in the emergency department after hospital admission, and boarding has been a growing problem in the United States. Boarding of the critically ill has achieved specific attention because of its association with poor clinical outcomes. Accordingly, the Society of Critical Care Medicine and the American College of Emergency Physicians convened a Task Force to understand the implications of emergency department boarding of the critically ill. The objective of this article is to review the U.S. literature on (1) the frequency of emergency department boarding among the critically ill, (2) the outcomes associated with critical care patient boarding, and (3) local strategies developed to mitigate the impact of emergency department critical care boarding on patient outcomes. ⋯ Emergency department boarding of critically ill patients was common and was associated with worse clinical outcomes. Health systems have generated a number of strategies to mitigate these effects. A definition for emergency department boarding is proposed. Future work should establish formal criteria for analysis and benchmarking of emergency department-based boarding overall, with subsequent efforts focused on developing and reporting innovative strategies that improve clinical outcomes of critically ill patients boarded in the emergency department.