The effect of long holidays on emergency department visits and cardiac emergencies

Abstract

Aims: Patients who visit the emergency department (ED) on holidays have delays in diagnosis and treatment due to a lack of personnel and equipment, and these holiday periods may result in increased morbidity and mortality. In this study, we aimed to investigate the impact of a nine-day holiday on ED admissions and admissions due to cardiac complaints in our country, Turkey. Methods: This was a retrospective study. Patients were analyzed in 4 periods: Pre-Eid-El-Fitr, Eid-El-Fitr, pre-Eid al-Adha, and Eid al-Adha. Waiting times in the ED, the left without being seen (LWBS), consultations, admission diagnoses of cardiac patients, referral status of cardiac patients, and hospitalization were examined. Results: The most frequent visits to the ED were on Eid al-Adha (n=6581, 40.1 %). The waiting time before the ED examination increased with the crowd, and the longest waiting time was observed during Eid al-Adha (38.09 ±51.74 min, p<0.001). LWBS rate was the highest during the Eid al-Adha (15.4%). It was observed that cardiac emergencies had shorter waiting times. Among the cardiac emergency patients, all NSTEMI patients could not be referred from the ED during the Eid al-Adha period due to the fullness of the angiography centers, and the patients were transferred to the intensive care unit when the beds became available. Conclusion: Due to the crowded EDs during extended holiday periods, the triage system gains importance for the early detection and treatment of cardiac patients. A regular patient flow chart should be established on a provincial basis to avoid delays in the treatment process of patients needing angiography.