RESUMEN
Overcrowding of emergency departments is a growing problem. Delays in admitting patients to inpatient units have been reported as a contributing factor to overcrowding. Overcrowding in ED results in many patients not receiving needed care and impairs the ability of the ED provider to meet the needs of those patients that are treated. The effect of the critically ill patients on the overcrowded emergency department make emergency physicians frustrated. So we created 'the special unit for observation' of critically ill patients and managed them continuously and closely. The special unit for observation have 4 physical beds and monitors and 2 ventilators. One nurse and senior ED residents were asigned to the management of the patients in the special unit. 160 patients(3.4% of all ED visits) admitted to special unit during the period of March 1, 1996 to May 31, 1996. we could continue assessment and management of critically ill patients without psychologic strain or burnout generated by overcrowding. We think that special unit for critically ill patients is a very effective alternative to overcrowded ED.