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OCR for page 23
Interrelationships between the Emergency Department and the
intensive Care Unit
In planning emergency facilities for the future and in redesigning
current facilities, it would seem advantageous to transfer certain
protracted functions of resuscitation out of the emergency rooms
and integrate them closely into the operation of the intensive care
unit. Recent developments have made the intensive care unit the
focal point of nursing and medical care in many large hospitals.
Concentrated in this area are resuscitation equipment, monitors,
respirators, defibrillatory, pacemakers, suction devices, and, above
all, the highly trained personnel needed for the care of the severely
ill medical case or the injured patient.
RECOMMENDATION
Expansion of intensive care programs to ensure uninterrupted care
beyond the immediate measures rendered in emergency departments.
THE DEVELOPMENT OF TRAUMA REGISTRIES
Emergency case records are often inadequate. Sufficient thought
has not been given to extracting information concerning the nature
of the accident, the clinical condition during transportation and at
the time of entry to the emergency department, the resuscitative
measures used, the response of the patient, the initial laboratory and
X-ray records, and, finally, the ultimate outcome with or without
temporary or permanent disability. This information is vital on
several scores. It is essential in recreating the circumstances of the
accident and in relating the mechanism of trauma to accident
prevention. It is necessary for clinical analysis, for improvement
of therapy, and for appraisal of emergency facilities. Finally, it
could provide a basis for determining the duration, nature and
degree of disability and the long-term, natural history of specific
injuries. An example of the need for long-term records of this type
is that of a patient in whom the ultimate manifestation of damage
to the femoral artery accompanying a fracture of the femur was
not apparent until 34 years later when generalized arteriosclerosis
developed, and thrombosis of the involved femoral artery necessi-
tated amputation. Information of this type on a broad scale could
be obtained by the development of trauma registries within the
23
Representative terms from entire chapter:
care unit
