Home - Journal of Emergency and Critical Care MedicineCritical illness and injury exact an enormous toll on patients, their families, and society. Patients presenting to the ED requiring intensive care are initially seen by traditional ED staff in the usual manner, and care is then transitioned to the EC3, where critical care is delivered by emergency physicians with and without critical care fellowship training. By using a standard set of evidence-based protocols, the staff of EC3 is able to accommodate patients with a wide variety of diagnoses common to the ICU, including septic shock, gastrointestinal tract bleeding, status epilepticus, and diabetic ketoacidosis, among others. Although these successes are remarkable, they are even more impressive when taken in the context of temporal increases in annual ED volume, acuity indicated by lower mean emergency severity index scores , and length of stay during the study period and greater mean age and medical complexity represented by increasing Charlson Comorbidity Index scores of the comparison cohort. Although the findings reported by Gunnerson et al 6 are notable and provide hope of a novel solution to the contemporary crisis of providing timely, high-quality critical care, the reproducibility of EC3 units at scale beyond a few large, specialized academic centers is uncertain without essential fiscal details. These considerations include the financing of EC3, both for initial capital eg, physical plant creation and equipment acquisition and ongoing personnel eg, physicians, advanced practice providers, nursing staff, and ancillary health professionals , operational costs eg, disposable equipment and specific training requirements for these specialized staff and physicians , and the role of foundation funding for these operations.
PRESSORS in the ICU - The MICU Series (Medical ICU)
Annual Update in Intensive Care and Emergency Medicine
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