Di Somma Salvatore, Paladino Lorenzo, Vaughan Louella, Lalle Irene, Magrini Laura, Magnanti Massimo
Department of Emergency Medicine, Faculty of Medicine and Psychology, Medical-Surgery Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy,
Intern Emerg Med. 2015 Mar;10(2):171-5. doi: 10.1007/s11739-014-1154-8. Epub 2014 Dec 2.
Overcrowding in the emergency department (ED) has become an increasingly significant worldwide public health problem in the last decade. It is a consequence of simultaneous increasing demand for health care and a deficit in available hospital beds and ED beds, as for example it occurs in mass casualty incidents, but also in other conditions causing a shortage of hospital beds. In Italy in the last 12-15 years, there has been a huge increase in the activity of the ED, and several possible interventions, with specific organizational procedures, have been proposed. In 2004 in the United Kingdom, the rule that 98 % of ED patients should be seen and then admitted or discharged within 4 h of presentation to the ED ('4 h rule') was introduced, and it has been shown to be very effective in decreasing ED crowding, and has led to the development of further acute care clinical indicators. This manuscript represents a synopsis of the lectures on overcrowding problems in the ED of the Third Italian GREAT Network Congress, held in Rome, 15-19 October 2012, and hopefully, they may provide valuable contributions in the understanding of ED crowding solutions.
在过去十年中，急诊科过度拥挤已成为一个日益严重的全球性公共卫生问题。这是医疗保健需求不断增加以及可用医院病床和急诊科床位短缺的结果，例如在大规模伤亡事件中会出现这种情况，在其他导致医院床位短缺的情况下也会出现。在意大利，过去12至15年中，急诊科的工作量大幅增加，并且已经提出了一些可能的干预措施以及具体的组织程序。2004年，英国引入了一项规定，即98%的急诊科患者应在就诊后4小时内接受诊治并入院或出院（“4小时规则”），事实证明该规则在减少急诊科拥挤方面非常有效，并促使了更多急性护理临床指标的制定。本手稿是2012年10月15日至19日在罗马举行的第三届意大利GREAT网络大会关于急诊科过度拥挤问题讲座的概要，希望它们能为理解急诊科拥挤问题的解决方案提供有价值的贡献。
