Critical care and emergency medicine

The delivery of critical care in the emergency department is a growing challenge that faces emergency physicians and intensivists. As emergency departments and intensive care units become increasingly crowded, critically ill patients will remain in the emergency department for longer periods of time. The care provided for critically ill patients during the emergency department stay significantly decreases the progression of organ failure and mortality. Further efforts to improve the quality of critical care in the emergency department would logically further reduce mortality and morbidity. As critical care requires significant resources including time from physicians and nurses, as well as physical resources including space, monitoring equipment, and medications, improving the quality of critical care delivery in the emergency department is not without obstacles. Resources are not limitless and the true goal is finding the point where delivering the best patient care possible occurs within the available resources of the emergency department and the hospital. This article describes the current status of critical care in the emergency department and discusses possible strategies for improvement.