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ER Crowding Kills

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In a recent Annals of Emergency Medicine, Benjamin Sun reported on the “The Effect of Emergency Department Crowding on Outcomes of Admitted Patients”.  It was reported in the popular press as “ER Crowding Kills”.

Perhaps a sensational headline but perhaps it is time that we called ED crowding for what it is, an unacceptable danger to public health.

Perhaps we have been too politically correct and too subdued in collective our commentary of the effects of crowding.  To a certain extent we have  let the politicians off the hook from which they deservedly deserve to hang.

Crowding has existed (or at least been documented) in Canada since 1988, twenty five years ago.  It represents in my view a national public disgrace.

Courtesy of trememdous Canadian and International research we know that crowding leads to increased patient morbidity and mortality, system gridlock, delays in ambulance offloading and increased costs to the health care system.  In short we make patients suffer unnecessarily and by allowing the situation to exist we drive up health care costs..

In this article, we are reminded yet again that crowding kills.  To quote the auhtors “Patients who were admitted on days with high ED crowding experienced 5% greater odfds of in-patient death, 0-.8% longer hospital length of stay and 1% increased costs per admission.”

Statistics are one thing but let’s put a human face on the effects of crowding.

Recently the Alberta press highlighted the premature death of Samuel Takyi and the judicial finding that crowding was contributory.

It is not just the old.

Vince Motta from Okotoks, Alberta died as a result of complications from appendicitis in 2001,  Pat Vepari died as a result of meningitis in Kitchener Waterloo in 2005 and Patrick Cleaves died in Halifax Nova Scotia in 2009 as a result of untreated asthma.

The common thread, young people in their twenties who left the ED because of a prolonged wait for care. 

How much more research do we really need before we recognize the moral imperative to fix ED crowding.  The problem is defined, the solutions are evident, the political will is lacking.
 
ER crowding does kill.  How many more people need to die?
 
 
 
 
 
 

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