What is the appropriate disposition statement for transfer from the Emergency Department (ED) to the Intensive Care Unit (ICU)?

From the Guidelines

The patient should be transferred to the ICU for close monitoring and management of their critical condition, with a focus on maintaining oxygenation and adequate blood pressure, and minimising rises in ICP 1.

Key Considerations for Transfer

• The patient should be physiologically stable before departure to minimize the risk of complications during transfer 1.
• A smooth journey with minimal acceleration and deceleration is crucial to prevent further injury to the patient 1.
• Constant vigilance and prompt action are necessary to address any complications that may arise during the transfer 1.
• The transfer team should be prepared to take prompt action to deal with any complications, and may need to bring the ambulance to a halt if a procedure needs to be performed 1.

Disposition Statement

The disposition statement should include the following: "The patient is being transferred to the ICU for close monitoring and management of their critical condition, with a focus on maintaining oxygenation and adequate blood pressure, and minimising rises in ICP. The patient will require ongoing care and monitoring, with a planned duration of stay of at least 24 hours, pending further evaluation and stabilization of their condition."

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Disposition Statement for Transfer from ED to ICU

The disposition statement for transfer from the Emergency Department (ED) to the Intensive Care Unit (ICU) is not directly addressed in the provided study 2. However, the study highlights the importance of preparedness and reorganization of care in the ICU to increase surge capacity and improve patient outcomes.

Key Considerations for Disposition Statement

• The study focuses on the reorganization of ICU care for coronavirus disease 2019 patients, including the increase of ICU bed capacity and adequate equipment and staffing 2.
• The results show that anticipation and preparedness ahead of the wave may account for the low mortality observed in the center 2.
• The study does not provide specific guidance on the disposition statement for transfer from the ED to the ICU, but it emphasizes the importance of resources management strategy in the context of the ongoing pandemic 2.

Relevant Information for Disposition Decision

• Patient characteristics, such as demographic data, comorbidities, laboratory values, and clinical outcomes, are crucial in determining the need for ICU admission 2.
• The study reports that among 129 critically ill patients with severe acute hypoxemic respiratory failure, 96% required invasive mechanical ventilation, and 81% were discharged alive 2.
• The decision to transfer a patient from the ED to the ICU should be based on individual patient needs and the availability of resources, including ICU bed capacity and staffing 2.