Evaluation of an emergency department observation ward

To evaluate the usefulness of an observation or holding area in the operation of an emergency department, the 166 cases held in the observation area of the Harbor General Hospital Emergency Department during September, 1974, were reviewed. Among the 166 patients, who made up 2% of the 10,452 patients seen in the ED that month, drug overdose and alcohol withdrawal were the primary disorders admitted, 42 and 34 respectively. Neurological disorders were next with 29 cases. Fluids administered intravenously, analgesics and sedatives were the most common therapeutic modalities used. Psychiatric was the type of consultation required most often. Seventy-seven of the 166 patients went home; 61 were admitted to the hospital and none died. Fifteen were transferred to nursing homes, 8 to to detoxification centers and 5 to a mental hospital. The advantages and disadvantages of an observation ward are listed and discussed.