The "golden hour" is the tenet of early intervention in surgical resuscitation. Due to inpatient crowding, this "golden hour" can frequently be hours in hospitals, requiring the provision of critical care in the ED.12 The benefit of ED care in nontraumatic critical illness has not been adequately studied. Using a measure of illness severity that also predicts mortality (APACHE II), a study of critically ill patients admitted to the medical critical care unit demonstrated that ED intervention significantly decreased the incidence of organ failure by 25 percent and predicted mortality by 12.5 percent. 3 This study, and others like it, provide evidence that expert and timely ED care reduces morbidity and mortality in patients with nontraumatic critical illness.
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