Impact of the Emergency Procedure Zone on Emergency Care
Abstract
:1. Introduction
2. Methods
2.1. Emergency Department
2.2. Emergency Procedure Zone
2.3. Data Collection
2.4. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
CVC | central venous catheter |
ED | emergency department |
EPZ | emergency procedure zone |
FAST | focused abdominal sonography for trauma |
LOS-ED | length of stay in the emergency department |
POCUS | point-of-care ultrasound |
References
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Pre-EPZ N = 137,141 n (%) | Post-EPZ N = 118,386 n (%) | p Value | ||
---|---|---|---|---|
Age | Adults (≥18 years) | 113,900 (83.1) | 102,539 (86.6) | <0.001 |
Children (<18 years) | 23,241 (16.9) | 15,847 (13.4) | ||
Gender | Male | 68,424 (49.9) | 58,583 (49.5) | 0.039 |
Female | 68,717 (50.1) | 59,803 (50.5) | ||
Mechanism | Trauma | 41,503 (30.3) | 27,984 (23.6) | <0.001 |
Non-trauma | 95,638 (69.7) | 90,402 (76.4) | ||
Triage acuity level | 1 | 5755 (4.2) | 5593 (4.7) | <0.001 |
2 | 20,727 (15.1) | 21,020 (17.8) | ||
3 | 103,450 (75.4) | 87,902 (74.3) | ||
4 | 6661 (4.9) | 2863 (2.4) | ||
5 | 548 (0.4) | 1008 (0.9) | ||
Disposition | Direct discharge from the emergency department | 96,814 (70.6) | 96,215 (81.3) | <0.001 |
Mean daily patient volume | 249.8 (0.1) | 216.8 (0.1) | <0.001 |
Pre-EPZ N = 137,141 n (%) | Post-EPZ N = 118,386 n (%) | p Value | ||
---|---|---|---|---|
Procedure | Suture | 6533 (4.76) | 4797 (4.05) | <0.001 |
CVC insertion | 612 (0.45) | 1572 (1.33) | <0.001 | |
Chest tube or pigtail placement | 292 (0.21) | 348 (0.29) | <0.001 | |
Thoracentesis | 543 (0.40) | 524 (0.44) | 0.073 | |
Abdominocentesis | 396 (0.29) | 281 (0.24) | 0.013 | |
Arthrocentesis | 42 (0.03) | 129 (0.11) | <0.001 | |
Lumbar puncture | 150 (0.11) | 408 (0.34) | <0.001 | |
Incision and drainage | 26 (0.02) | 123 (0.10) | <0.001 | |
Reduction | 199 (0.15) | 183 (0.15) | 0.571 | |
Splint | 378 (0.28) | 253 (0.21) | 0.002 | |
Ultrasound | Total of ultrasound scans | 10,060 (7.34) | 12,053 (10.18) | <0.001 |
Ultrasound performed in the emergency department (ED) | 2026 (1.48) | 5370 (4.54) | <0.001 | |
Focused abdominal sonography for trauma (FAST) in the ED | 1426 (1.04) | 2704 (2.28) | <0.001 | |
Non-FAST in the ED | 600 (0.44) | 2666 (2.25) | <0.001 | |
Ultrasound performed in the radiology or cardiology department | 8034 (5.86) | 6683 (5.65) | 0.022 |
Pre-EPZ N = 96,814 n (%) | Post-EPZ N = 96,215 n (%) | p Value | ||
---|---|---|---|---|
Procedure | Suture | 5507 (5.69) | 3938 (4.09) | <0.001 |
CVC insertion | 18 (0.02) | 67 (0.07) | <0.001 | |
Chest tube or pigtail placement | 10 (0.01) | 8 (0.01) | 0.824 | |
Thoracentesis | 157 (0.16) | 153 (0.16) | 0.908 | |
Abdominocentesis | 210 (0.22) | 146 (0.15) | <0.001 | |
Arthrocentesis | 17 (0.02) | 64 (0.07) | <0.001 | |
Lumbar puncture | 33 (0.03) | 133 (0.14) | <0.001 | |
Incision and drainage | 12 (0.01) | 86 (0.09) | <0.001 | |
Reduction | 157 (0.16) | 144 (0.15) | 0.523 | |
Splint | 269 (0.28) | 189 (0.20) | 0.003 | |
Ultrasound | Overall | 3814 (3.94) | 5487 (5.7) | <0.001 |
Ultrasound performed in emergency department (ED) | 1257 (1.30) | 3339 (3.47) | <0.001 | |
Focused abdominal sonography for trauma (FAST) in the ED | 902 (0.93) | 1731 (1.80) | <0.001 | |
Non-FAST in the ED | 355 (0.37) | 1608 (1.67) | <0.001 | |
Ultrasound performed in the radiology or cardiology department | 2557 (2.64) | 2148 (2.23) | <0.001 |
Pre-EPZ Median (IQR) (min) | Post-EPZ Median (IQR) (min) | p Value | |
---|---|---|---|
The LOS-ED for all patients | 110 (53–127) | 102 (33–208) | <0.001 |
The LOS-ED for patients who underwent procedures | |||
Suture | 72 (43–141) | 105 (64–186) | <0.001 |
CVC | 1154 (308–1658) | 1198 (476–2076) | 0.687 |
Chest tube or pigtail placement | 1425 (236–2684) | 288 (213–479) | 0.083 |
Thoracentesis | 379 (224.3–1103.5) | 481 (285.3–1275.8) | 0.018 |
Abdominocentesis | 229 (136–384) | 265 (149–410) | 0.276 |
Arthrocentesis | 258 (151–662) | 241 (154–581) | 0.672 |
Lumbar puncture | 1222 (469.3–1636.8) | 1271 (720.8–2270.5) | 0.304 |
I&D | 333.5 (181–2332.5) | 109 (54–227) | 0.002 |
Reduction | 107 (62.8–183.3) | 150 (80.0–220.0) | 0.007 |
Splint | 156 (111.8–231.3) | 189 (119.0–272.5) | 0.007 |
The LOS-ED for patients who underwent ultrasound scans | |||
Overall | 365 (166–926) | 270 (143–551) | <0.001 |
Ultrasound performed in the emergency department (ED) | 124 (68–280) | 180 (109–305) | <0.001 |
Focused abdominal sonography for trauma (FAST) in the ED | 112 (63–238) | 158 (93–277.8) | <0.001 |
Non-FAST in the ED | 166 (86–335) | 204 (129–339) | <0.001 |
Ultrasound performed in the radiology or cardiology department | 562 (297–1203) | 535 (309–1254) | 0.470 |
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Lin, I.-C.; Chiu, P.-W.; Lin, C.-H. Impact of the Emergency Procedure Zone on Emergency Care. Medicina 2023, 59, 901. https://doi.org/10.3390/medicina59050901
Lin I-C, Chiu P-W, Lin C-H. Impact of the Emergency Procedure Zone on Emergency Care. Medicina. 2023; 59(5):901. https://doi.org/10.3390/medicina59050901
Chicago/Turabian StyleLin, I-Chen, Po-Wei Chiu, and Chih-Hao Lin. 2023. "Impact of the Emergency Procedure Zone on Emergency Care" Medicina 59, no. 5: 901. https://doi.org/10.3390/medicina59050901