Freestanding emergency departments and the trauma patient

Abstract

Background: Freestanding emergency departments (FEDs) continue to grow in number and more research is needed on these facilities.

Objective: We sought to characterize the types of injuries and patients who initially presented to two FEDs and were transferred to the main tertiary care ED for trauma team consult and admission.

Methods: This retrospective cohort descriptive study examined medical records of adult trauma patients who were initially seen at an FED and then transferred to the main ED. All patients who received a trauma consultation were included. Data collection included demographics, initial mode of transport to the ED, injury, mechanism of injury, ED, hospital course and outcome.

Results: Mean age was 61.8 ± 23.8, 96.7% were Caucasian and 52.5% were male. Mode of transport to the FEDs included private vehicle (46.4%) and emergency medical services (53.6%). The main injury mechanisms were fall from standing (51.9%) and fall from an object (16%). A total of 12.7% were from motor vehicle accidents and 6.6% presented from bicycle and all-terrain vehicle accidents. Blunt traumatic injuries accounted for 97.8% (n = 177) patients. Computed tomography scanning was performed on 90.1% of patients. Median ED length of stay was 189 min. Mean hospital length of stay was 3 days and 2.2% (n = 4) of patients died from their injuries.

Conclusions: Understanding the patients and traumatic injuries that present to FEDs will guide training and identify resources needed for patients requiring additional care at a trauma center.

Keywords: freestanding emergency departments; tertiary care; trauma.