JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
Transition from emergency department to intensive care: the contribution of detailed anamnesis and early imaging to diagnosis and treatment processes
Abstract
Aims: The overcrowding of emergency departments (EDs) is a significant public health issue that diminishes the quality of healthcare services and increases mortality and morbidity rates both nationally and internationally. This study aims to emphasize the importance of detailed anamnesis and early bedside non-invasive imaging (ultrasonography) in patients transferred from the ED to the intensive care unit (ICU). It also addresses the impact of ED overcrowding on healthcare services and proposes solutions to enhance healthcare quality.
Methods: Between June 20, 2024, and November 25, 2024, patients over 18 years admitted to the ICU via the adult ED at Mardin Training and Research Hospital for various reasons were included in the study. A detailed anamnesis and non-invasive ultrasonographic imaging were performed for all ICU-admitted patients.
Results: Among the 242 patients admitted to the ICU, additional findings that influenced treatment decisions were identified in 21 patients through detailed anamnesis and imaging. Of these patients, 11 were male and 10 were female. The most frequent admission diagnoses were traffic accidents [8/21, (38.1%)] and respiratory distress [6/21, (28.6%)].
Conclusion: Our study demonstrates that performing detailed anamnesis and utilizing non-invasive imaging techniques in patients transferred from the ED to the ICU provides critical contributions to diagnosis and treatment. Strategies should be developed to reduce unnecessary ED visits and promote the appropriate use of emergency services.

Keywords : Emergency department, intensive care unit, ultrasonography, detailed anamnesis, echocardiography

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1. Cakmak F, Ikizceli I, Ozturk D, et al. Emergency Department length of stay for critically ill patients followed up in red zone. Signa Vitae. 2021; 17(1):63-68. doi:10.22514/sv.2020.16.0048
2. Hoot NR, Aronsky D. Systematic review of emergency department crowding: causes, effects, and solutions. Ann Emerg Med. 2008;52(2):126-136. doi:10.1016/j.annemergmed.2008.03.014
3. Gill JM, Riley AW. Nonurgent use of hospital emergency departments: urgency from the patient's perspective. J Fam Pract. 1996;42(5):491-496.
4. Bakanlığı TS. Sağlık Hizmetleri Genel Müdürlüğü Sağlıkta Kalite ve Akreditasyon Daire Başkanlığı. Sağlıkta kalite standartları hastane versiyon-5 Ankara. Accessed 04 Sep 2024, 2024. https://shgmkalitedb.saglik.gov.tr/TR-12681/arsiv-sks-standartlari.html
5. Roland MO, Bartholomew J, Courtenay MJ, Morris RW, Morrell DC. The "five minute" consultation: effect of time constraint on verbal communication. Br Med J. 1986;292(6524):874-876. doi:10.1136/bmj. 292.6524.874
6. McQuillan P, Pilkington S, Allan A, et al. Confidential inquiry into quality of care before admission to intensive care. BMJ. 1998;316(7148): 1853-1858. doi:10.1136/bmj.316.7148.1853
7. Beaulieu Y, Marik PE. Bedside ultrasonography in the ICU: part 1. Chest. 2005;128(2):881-895. doi:10.1378/chest.128.2.881
8. Eren G, Herg&uuml;nsel O, &Ccedil;ukurova Z, Doğan Y, Karakaya O. Yoğun bakımda kardiyopulmoner monitorizasyonda g&uuml;nl&uuml;k pratiğimizde &ldquo;yeni&rdquo; bir ara&ccedil;: transtorasik ekokardiyografi ve akciğer ultrasonu. Turk J Intensive Care. 2012;10(1):13. doi<strong>:</strong>10.4274/Tybdd.37
9. Hwang JJ, Shyu KG, Chen JJ, Tseng YZ, Kuan P, Lien WP. Usefulness of transesophageal echocardiography in the treatment of critically ill patients. Chest. 1993;104(3):861-866. doi:10.1378/chest.104.3.861
10. Cook CH, Praba AC, Beery PR, Martin LC. Transthoracic echocardiography is not cost-effective in critically ill surgical patients. J Trauma. 2002;52(2):280-284. doi:10.1097/00005373-200202000-00013
11. Stanescu L, Talner LB, Mann FA. Diagnostic errors in polytrauma: a structured review of the recent literature. Emerg Radiol. 2006;12(3):119-123. doi:10.1007/s10140-005-0436-x
12. Lee C, Bleetman A. Commonly missed injuries in the accident and emergency department. Trauma. 2004;6(1):41-51. doi:10.1191/ 1460408604ta298oa
13. Karaca MA, Erbil B, &Ouml;zmen MM. Waiting in the emergency room: patient and attendant satisfaction and perception. Eur J Surg Sci. 2011; 2(1):1-4
14. Derlet RW. Overcrowding in emergency departments: increased demand and decreased capacity. Ann Emerg Med. 2002;39(4):430-432. doi:10.1067/mem.2002.122707
15. Mahony SO, Blank A, Simpson J, et al. Preliminary report of a palliative care and case management project in an emergency department for chronically ill elderly patients. J Urban Health. 2008;85(3):443-451. doi: 10.1007/s11524-008-9257-z
16. Beynon T, Gomes B, Murtagh FE, et al. How common are palliative care needs among older people who die in the emergency department? Emerg Med J. 2011;28(6):491-495. doi:10.1136/emj.2009.090019
17. Mullins PM, Goyal M, Pines JM. National growth in intensive care unit admissions from emergency departments in the United States from 2002 to 2009. Acad Emerg Med. 2013;20(5):479-486. doi:10.1111/acem.12134
18. Şahin S, Boydak B, Savaş S. Acil servise başvuran 65 yaş ve &uuml;zeri hastaların &ouml;zellikleri. Akad Geiartri. 2011;3(3):41-46.
19. Şahin S, Boydak B, Savaş S, Yal&ccedil;ın M, Ak&ccedil;i&ccedil;ek F. Acil servise başvuran 65 yaş ve &uuml;zeri hastaların &ouml;zellikleri. Akademik Geriatri Dergisi. 2011; 3(3):41-46.
20. Goldhill DR, Sumner A. Outcome of intensive care patients in a group of British intensive care units. Crit Care Med 1998;26(8):1337-1345. doi: 10.1097/00003246-199808000-00017
21. Fassier T, Duclos A, Abbas-Chorfa F, et al. Elderly patients hospitalized in the ICU in France: a population-based study using secondary data from the national hospital discharge database. J Eval Clin Pract. 2016; 22(3):378-386. doi:10.1111/jep.12497
22. Flaatten H, De Lange DW, Morandi A, et al. The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (&gt;/= 80 years). Intensive Care Med. 2017;43(12):1820-1828. doi:10.1007/s00134-01 7-4940-8
23. Kachalia A, Gandhi TK, Puopolo AL, et al. Missed and delayed diagnoses in the emergency department: a study of closed malpractice claims from 4 liability insurers. Ann Emerg Med. 2007;49(2):196-205. doi:10.1016/j.annemergmed.2006.06.035
24. Enderson BL, Reath DB, Meadors J, Dallas W, DeBoo JM, Maull KI. The tertiary trauma survey: a prospective study of missed injury. J Trauma. 1990;30(6):666-669.
25. Houshian S, Larsen MS, Holm C. Missed injuries in a level I trauma center. J Trauma. 2002;52(4):715-719. doi:10.1097/00005373-200204000-00018
26. Chan RN, Ainscow D, Sikorski JM. Diagnostic failures in the multiple injured. J Trauma. 1980;20(8):684-687. doi:10.1097/00005373-198008000-00009
27. Ala-Kokko TI, Ohtonen P, Koskenkari J, et al. Improved outcome after trauma care in university-level intensive care units. Acta Anaesthesiol Scand. 2009; 53(10):1251-1256. doi:10.1111/j.1399-6576.2009.02072.x
28. Halsted MJ, Kumar H, Paquin JJ, et al. Diagnostic errors by radiology residents in interpreting pediatric radiographs in an emergency setting. Pediatr Radiol. 2004;34(4):331-336. doi:10.1007/s00247-004-1150-7
29. Karcz A, Korn R, Burke MC, et al. Malpractice claims against emergency physicians in Massachusetts: 1975-1993. Am J Emerg Med. 1996;14(4): 341-345. doi:10.1016/S0735-6757(96)90044-3
30. Guly HR. Diagnostic errors in an accident and emergency department. Emerg Med J. 2001;18(4):263-269. doi:10.1136/emj.18.4.263
31. Razzaq QM. Use of the &#39;sliding lung sign&#39; in emergency bedside ultrasound. Eur J Emerg Med. 2008;15(4):238-241. doi:10.1097/MEJ. 0b013e3282f4d15b
32. Garc&iacute;a-Gigorro R, de la Cruz Vigo F, Andr&eacute;s-Esteban EM, et al. Impact on patient outcome of emergency department length of stay prior to ICU admission. Med Intensiva. 2017;41(4):201-208. doi:10.1016/j.medin.2016. 05.008
Article available in :
Volume 6, Issue 2, 2025
Page : 85-90
https://doi.org/10.47582/jompac.1623179
Article Information
Received : 19 Oca 2025
Accepted : 04 Mar 2025
Published : 23 Mar 2025
Corresponding Author :

Semih Aydemir: Department of Anesthesiology and Reanimation, Yıldırım Beyazıt University Yenimahalle Training and Research Hospital, Ankara, Turkiye

[email protected]
Citation : Kılınç M, Çelik E, Demir İ, Aydemir S, Akelma H. Transition from emergency department to intensive care: the contribution of detailed anamnesis and early imaging to diagnosis and treatment processes. J Med Palliat Care. 2025;6(2):85-90.

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