Related Experiment Video
Updated: May 16, 2026
09:47
A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique
Published on: April 26, 2015
Association between ED crowding and delay in resuscitation effort
Ki Jeong Hong1, Sang Do Shin, Kyoung Jun Song
1Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea. emkjhong@gmail.com
The American Journal of Emergency Medicine
|November 20, 2012
Summary
Emergency department crowding increases the risk of delayed resuscitation efforts (DREs), leading to significantly higher in-hospital mortality for emergency patients. Addressing ED crowding is crucial for improving patient outcomes.
Area of Science:
- Emergency Medicine
- Healthcare Management
- Patient Safety
Background:
- Emergency department (ED) crowding is a growing concern linked to adverse patient outcomes.
- The specific mechanisms by which ED crowding impacts hospital mortality remain under-investigated.
Purpose of the Study:
- To determine if ED crowding is associated with delayed resuscitation efforts (DREs).
- To evaluate the impact of DREs on hospital mortality in emergency patients.
Main Methods:
- Retrospective observational study of adult patients in a single urban tertiary ED resuscitation room (October 2008 - May 2010).
- Crowding defined by daily patient volume exceeding 93; DRE defined as resuscitation after clinical deterioration in hallway/waiting room.
- Propensity score matching used to compare DRE and non-DRE groups, with logistic regression for analysis.
Main Results:
- A total of 1296 patients were analyzed; 17.4% experienced DREs.
- DREs occurred significantly more often on crowded days (OR, 2.00; 95% CI, 1.28-3.15).
- The DRE group had significantly higher in-hospital mortality (OR, 3.96; 95% CI, 2.28-6.88).
Conclusions:
- Delayed resuscitation efforts are more frequent during periods of ED crowding.
- DREs are significantly associated with increased in-hospital mortality for emergency patients.
Related Concept Videos
01:21Cardiopulmonary Resuscitation I: Adult
Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
01:23Cardiopulmonary Resuscitation III: AED Use
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
01:23Acute Respiratory Failure-IV
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...