Evidence map›Paper›PMID 32191190›Full record

ArticleThe western journal of emergency medicine2020

Triage and Ongoing Care for Critically Ill Patients in the Emergency Department: Results from a National Survey of Emergency Physicians.

Kusum S Mathews, Sandra M Rodriguez, Judith E Nelson, Lynne D Richardson

Abstract readMulticenter Study
In one paragraph

Article in The western journal of emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kusum S MathewsIcahn School of Medicine at Mount Sinai, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York, New York.
Sandra M RodriguezIcahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New York.
Judith E NelsonMemorial Sloan Kettering Cancer Center, Weill Cornell College of Medicine, Departments of Medicine and Anesthesiology and Critical Care, New York, New York.
Lynne D RichardsonIcahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New York.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
MOUNT SINAI EMERGENCY MEDICINE RESEARCH CAREER DEVELOPMENT PROGRAMK12HL109005 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI RICHARDSON, LYNNE D. · 2011 to 2015
$3.9M
Optimizing ED to ICU triage decisions for critically ill patients in respiratory distressK23HL130648 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI MATHEWS, KUSUM SARA · 2016 to 2021
$744k
NCI NIH HHS P30 CA008748NHLBI NIH HHS K12 HL109005NHLBI NIH HHS K23 HL130648
6 · The paper itself

Abstract

introductionWe conducted a cross-sectional study at the Icahn School of Medicine at Mount Sinai to elicit emergency physician (EP) perceptions regarding intensive care unit (ICU) triage decisions and ongoing management for boarding of ICU patients in the emergency department (ED). We assessed factors influencing the disposition decision for critically ill patients in the ED to characterize EPs' perceptions about ongoing critical care delivery in the ED while awaiting ICU admission.

methodsThrough content expert review and pilot testing, we iteratively developed a 25-item written survey targeted to EPs, eliciting current ICU triage structure, opinions on factors influencing ICU admission decisions, and views on caring for critically ill patients "boarding" in the ED for >4-6 hours.

resultsWe approached 732 EPs at a large, national emergency medicine conference, achieving 93.6% response and completion rate, with 54% academic and 46% community participants. One-fifth reported having formal ICU admission criteria, although only 36.6% reported adherence. Common factors influencing EPs' ICU triage decisions were illness severity (91.1%), ICU interventions needed (87.6%), and diagnosis (68.2%), while ICU bed availability (13.5%) and presence of other critically ill patients in ED (10.2%) were less or not important. While 72.1% reported frequently caring for ICU boarders, respondents identified high patient volume (61.3%) and inadequate support staffing (48.6%) as the most common challenges in caring for boarding ICU patients.

conclusionPatient factors (eg, diagnosis, illness severity) were seen as more important than system factors (eg, bed availability) in triaging ED patients to the ICU. Boarding ICU patients is a common challenge for more than two-thirds of EPs, exacerbated by ED volume and staffing constraints.

Indexed as

AdultCritical CareCritical IllnessCross-Sectional StudiesEmergency Service, HospitalFemaleHumansMaleSurveys and QuestionnairesTriageUnited States

Identifiers

PMID32191190
PMCPMC7081882

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.