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Ambulance Diversion Is Not A New Phenomenon

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As the ultimate safety net, Emergency Departments (EDs) are expected to care for any patient, at any time, under any circumstance. When EDs are overwhelmed in periods of surge, one solution is to redistribute the patients. A commonly used method of redistributing patients is ambulance diversion. Ambulance diversion is not a new phenomenon, and over time has become commonly employed by EDs to address the growing problem of ED overcrowding and saturation.1 As ED visits have increased through the years, ambulance diversion has evolved into standard practice in many health systems. Along with this, ambulance diversion has always been controversial whether it is actually beneficial or detrimental to the patient, EMS systems, and hospitals. In…show more content…
These delays have also attributed to adverse medical outcomes. Recent data support that ambulance diversion does not work to ease ED overcrowding and may result in the worsening of patient care. Studies have shown that ambulance diversion can lead to delays for patients to obtain definitive medical care with increased field time and transport time and distances2,3 and can result in adverse outcomes including death. Diversion increases traffic accident risks, and may malposition EMS resources. Additionally, some patients may require specialty resources only available at the requested hospital and may not be able to receive at an alternate destination. There is a possible association between ED diversion and increased mortality in certain populations of patients, such as trauma and acute MI patients.4,5 Studies like these led to ACEP forming an EMS taskforce to review the topic of ambulance diversion. The taskforce penned the position paper that stated, “Ambulance diversion should occur only after the hospital has exhausted all internal mechanisms to avert a diversion, which includes calling in overtime staff.”6 The National Association of EMS Physicians (NAEMSP) also states that, “…ambulance diversion has not been shown to improve ED patient throughput.”7 It has been demonstrated that if one hospital goes into ED diversion status, an oscillatory
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