The concept of an emergency admission unit in a major community hospital
Necek, S.; Bergmann, H.
Der Anaesthesist 39(10): 463-468
1990
ISSN/ISBN: 0003-2417 PMID: 2278363 Document Number: 354312
The main task of a central interdisciplinary emergency admission unit (EAU) staffed and administered by the anesthesia department is to provide primary hospital treatment for emergency patients. The EAU serves also as a base for the emergency ambulance and functions as a 24-hour resuscitation unit for the whole hospital. The placement of the unit in the underground floor of the hospital makes it easy accessible for ambulances but excludes walk-in patients. The shock room has a floor area of 152 m2 and is optimally equipped, while two smaller emergency rooms provide reserve accommodation. On the same level are the X-ray department, emergency operating room, trauma team taking care of minor injuries and the medical house officer. The last two and the admissions clerk are responsible for selecting the real emergencies out of 9000 of urgent cases and patients with minor traumas entering the hospital on this level. In the first 40 months of EAU activity 1.2% of total hospital admissions (300-400 patients from a total number of 33,000 a year) were treated in the EAU; 71% of emergencies arrived by our own emergency ambulance or by helicopter, while others were brought by the Red Cross Emergency Service. The majority of acute cases (42.7%) are traumatic; 17.4% have circulatory problems, 10.8% neurological problems, 10.1% are suicidal, 1.5% are dead on arrival and the rest (17.5%) has other origins. From the total number of 1046 living admissions, 99 patients required cardiopulmonary resuscitation (21 = 20.6% were discharged), 25.0% of the total number underwent emergency surgery, and 43% needed intensive care. A general admission unit for pure emergencies is still a unique organizational feature in hospitals. The main objective of the EAU is to increase patient's safety during transition from prehospital to primary hospital acute care. EAU anesthesia staff ensures the competency in acute care and even the continuity of care by the same person from the emergency ambulance to the operating room or ICU.