Abstract
Background
Community emergency physicians (EPs) are often required to respond to unstable patients
outside of their department during off-hours.
Objective
The primary objective of this study was to describe the critical care responsibility
of community EPs outside of their departments.
Methods
A one-page survey was mailed to emergency department (ED) directors of 10 states and
Washington, DC.
Results
Three hundred forty of 1169 surveys were returned. The median (interquartile range
[IQR]) number of hospital and intensive care unit (ICU) beds was 145 (IQR 60–242)
and 11 (IQR 6–20), respectively. Median ED annual volume and ICU admission percentage
was reported to be 25 K (IQR 14–40) and 5% (IQR 2–10), respectively. Seventy-six percent of reporting institutions
require EPs to leave their department and respond to medical codes on the floors after
hours. In 57% of institutions, the EP was the only physician required to respond.
In addition, 48% of EPs must respond to unstable patients in the ICUs after hours.
Hospitals in which EPs were required to respond to medical codes and unstable ICU
patients were more likely to have fewer hospital beds (137 vs. 275; p<0.001), fewer ICU beds (12 vs. 27; p<0.001), and have a smaller ED annual volume (24 K vs. 39 K; p<0.001).
Conclusions
Many community EPs are responsible for covering critically ill patients outside of
their ED. Further investigation is required to determine the impact on patient care.
Keywords
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Article info
Publication history
Published online: January 10, 2011
Accepted:
November 4,
2010
Received in revised form:
June 30,
2010
Received:
January 25,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Emergency Physician Coverage of In-hospital CodesJournal of Emergency MedicineVol. 45Issue 1
- PreviewWe read the recent article “Quantifying Off-hour Emergency Physician Coverage of In-hospital Codes: A Survey of Community Emergency Departments” by Sherwin et al., and would like to comment on this important issue (1). Although Emergency Physicians (EPs) are able to adapt to exigent circumstances and typically want to help any patient in need of emergency care, it should be a rare situation and not the expected rule for EPs to leave their Emergency Department (ED) duties to provide inpatient care.
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