Critical Care in the Emergency Department: An assessment of the length of stay and invasive procedures performed on critically ill ED patients
Bibliographic record
Abstract
INTRODUCTION: Critically ill patients commonly present to the ED and require aggressive resuscitation. Patient transfer to an ICU environment in an expedient manner is considered optimal care. However, this patient population may remain in the ED for prolonged periods of time. The goal of this study is to describe the ED length of stay, and the invasive procedures performed in critically ill ED patients. METHODS: This is a retrospective medical record review of all patients who presented to the study center over a 1 year period. Patient demographic data, in addition to the times of ED presentation and ICU admission were recorded. Invasive procedures performed in the pre-hospital, ED and the initial 24 hours of ICU care were also recorded. RESULTS: Overall, 178 patients' required direct admission to an ICU from the ED, with a mortality rate of 21.9%. The median LOS in the ED for critically ill patients requiring ICU admission was 4.9 h (mean 6.5 h, range 1.4-28.2 h). Seventy percent of patients (125,178, 70.2%) required endotracheal intubation with the majority (118/125, 94.4%) being performed in the ED (80/125, 64.0%) or the prehospital setting (38/125, 30.4%). Central venous access was obtained in 56/178 patients (31.5%), with 17.9% (10/56) completed in the ED. Similarly, arterial catheters were inserted in 99/178 patients (55.6%) with 14.1% (14/99) inserted in the ED. CONCLUSION: Critically ill patients are managed in the emergency department for a significant length of time. Although the majority of airway intervention occurs in the prehospital setting and ED, relatively few patients undergo invasive procedures while in the emergency department.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".