Because our PICU is increasingly at capacity and "closed" to additional patients, our hospital has begun designating the ED as "PICU overflow." Hospital inpatients who deteriorate on the floor are taken to the ED, and handed off to the ED physician for management. Our ED physicians are comfortable with immediate resuscitation, but are unhappy with managing ventilators and ventilator sedation for extended periods, as well as trying to manage these often-complex patients with multi-system issues, all the while running a busy ED. Are other hospitals using the PED as a PICU overflow for deteriorating in-patients? If so, do you place any limits on who manages these patients, for how long, and with what assistance (e.g., co-management with hospitalist or critical care doc)?
Thanks for sharing your thoughts and/or experiences.
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