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Updated: Jun 19, 2026
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Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Critical care in the emergency department.
Gabrielle O'Connor1, Una Geary, James Moriarty
1Department of Emergency Medicine, St James' Hospital, Dublin, Ireland. gabbyoco@yahoo.com
Summary
Critically ill patients in the emergency department (ED) require significant nursing resources. A study found that high-acuity patients, using the Therapeutic Intervention Scoring System (TISS)-28, needed an estimated 3 hours and 13 minutes of nursing time per patient.
Area of Science:
- Critical care medicine
- Emergency medicine
- Healthcare resource management
Background:
- Increasing volume and length of stay for critically ill patients in emergency departments (EDs).
- Factors influencing ED stay include patient case-mix, overcrowding, intensive care bed availability, and an aging population.
- Need to understand clinical activity and resource utilization of high-acuity ED patients.
Purpose of the Study:
- To describe clinical activity of critically ill patients in the ED.
- To quantify resource utilization by this patient group.
Main Methods:
- Retrospective review of ED notes for patients referred to the intensive care team (April-September 2004).
- Utilized the Therapeutic Intervention Scoring System (TISS)-28, a validated tool for measuring nursing resource input.
- Defined a nurse's capacity as 46 TISS-28 points per 8-hour shift.
Main Results:
- Median TISS-28 score for 69 patients was 19 points.
- Estimated 3 hours and 13 minutes of nursing time per critically ill ED patient with a TISS score of 19.
- Indicates substantial personnel resource requirements for high-acuity ED patients.
Conclusions:
- High-acuity patients in the ED demand significant nursing personnel resources.
- Development of ED-validated models is crucial for quantifying nursing and medical staff resource use.
- Effective resource planning and allocation are needed to meet service demands in EDs.
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