The changing landscape of health care has resulted in an increase in the delivery of critical care in the emergency department. Although the emergency department duration is brief compared with the total length of hospitalization, physiologic determinants of outcome may be established before ICU admission. The care provided during the emergency department stay for critically ill patients has been shown to significantly impact the progression of organ failure and mortality. Despite these trends, formal critical care training for emergency physicians is limited.
The need to maximize patient throughput in frequently overcrowded emergency departments hinders the provision of optimal care to the critically ill patient. Methodologies should be developed to examine the quality of patient care and objectively measure the impact of clinical interventions. The potential to improve outcome through educational initiatives and resource allocation should not be viewed as a burden of delivering a higher level of care in this setting but as a significant opportunity to effectively mitigate the socioeconomic consequences.
From: Critical care and emergency medicine. Curr Opin Crit Care. 2002 Dec;8(6):600-6.
Critical care is the delivery of medical care to ‘‘any patient who is physiologically unstable, requiring constant and minute-to-minute titration of therapy according to the evolution of the disease process.’’ This definition extends to any location such that critical care is defined physiologically rather than geographically. The changing landscape of health care has resulted in an increase in the delivery of critical care in the emergency department (ED). Although the ED duration is brief compared to the total length of hospitalization, physiologic determinants of outcome may be established before intensive care unit (ICU) admission.
The care provided during the ED stay for critically ill patients has been shown to significantly impact the progression of organ failure and mortality. The increasing realization of the critical intersection of emergency medicine and critical care has led to a growing subspecialty in critical care medicine with formal education and training.
The Division of Emergency Critical Care Medicine at the Brigham and Women’s Hospital Department of Emergency Medicine is a multi-disciplinary, collaborative, and innovative group of faculty and staff dedicated to providing outstanding critical care to patients in our EDs and ICUs, educating residents, students, and fellows on the fundamental principles of critical care and its application in the emergency department, and cross collaborative research that traverse the ED, Medical and Surgical ICUs. Emergency Medicine has emerged as a significant contributor to the discipline of critical care and is poised to make tremendous impact on the care of the critically ill through education, research, and clinical practice.
To deliver outstanding critical care to patients within and beyond the geographic boundaries of the ED by developing and promoting innovative and collaborative clinical care, education, and research.
The Division of Emergency Critical Care Medicine will further the growth and development of the interface of critical care and emergency medicine. The Division will accomplish this through high quality multidisciplinary care models, innovative research, and collaborative education. The division will be the first division of emergency medicine critical care in Massachusetts and will exemplify the best of a culture of cross department collaboration.