Deaths had been above pre-pandemic ranges in 17 hospital EDs final 12 months
Greater than 5,000 individuals died in emergency departments (EDs) previously 5 years, together with over 1,000 final 12 months alone – nearly 200 greater than in 2019, new figures reveal.
Knowledge from the nation’s 26 EDs exhibits that Cork College Hospital noticed the very best variety of sufferers die in its emergency setting. Final 12 months 158 individuals had been pronounced useless there, down from 183 the 12 months earlier than. In 2019, 109 individuals handed away there.
In comparison with the pre-pandemic 12 months, ED fatalities rose in 17 hospitals in 2023. Three websites – Beaumont Hospital in Dublin, College Hospital Galway and Sligo College Hospital – noticed greater than twice as many deaths in its ED in comparison with 2019.
The figures had been equipped to Irish Medical Instances following a sequence of Freedom of Data requests and embrace deaths which passed off in EDs in addition to individuals who had been pronounced useless on arrival.
Only a handful stored information on the common size of time sufferers had been in ED once they died. In Beaumont, this time fell from 9 hours and 54 minutes in 2019 to seven hours and 42 minutes final 12 months.
Cork College Hospital noticed the very best variety of sufferers die in its emergency setting. Pic: Denis Scannell
Nonetheless, in St Vincent’s College Hospital, common instances rose by nearly 50 per cent, from eight hours and 33 minutes to 12 hours and 43 minutes. The Dublin hospital noticed the second largest variety of deaths in its ED, with 105 individuals passing away there final 12 months.
In response, St Vincent’s stated there are a number of components that result in ED deaths, together with the quantity and age profile of its sufferers and their degree of sickness. It added that every one deaths in its ED are reviewed by the hospital to enhance its outcomes.
A press release from the hospital stated that it’s “serving a catchment space with the very best variety of older individuals and extra nursing houses than in another a part of the nation.”
Deaths in EDs have made the headlines in latest months within the wake of the inquest into the dying of sepsis affected person Aoife Johnston, which recorded a verdict of medical misadventure. Two days earlier than her dying the 16-year-old skilled a prolonged look forward to therapy at College Hospital Limerick (UHL).
Within the final 5 years 239 individuals died within the ED at UHL. Nonetheless, whereas 58 sufferers handed away there in 2019, this quantity fell to 41 final 12 months.
A complete of 5,428 individuals died within the nation’s EDs previously 5 years. Whereas 1,161 individuals died in Irish EDs final 12 months, the determine is barely down on the 1,210 deaths seen in 2022. Nonetheless, it’s 182 greater than the 979 who died in 2019.
A complete of 9 hospitals noticed ED mortality figures keep the identical or fall, together with Our Girl’s Hospital in Navan which skilled only one ED dying final 12 months after a brand new HSE plan meant that ambulances would now not convey critically unwell sufferers to the Meath web site.
President of the Irish Affiliation for Emergency Drugs, Prof Conor Deasy, pointed to a lot of components that result in ED deaths, together with that the survival fee for out-of-hospital cardiac arrest (OHCA) is simply seven per cent. “These instances are delivered to the closest ED, and so understanding {that a} proportion (of deaths) are OHCA is worth it,” he stated.
He additionally referred to the problem of nursing house residents who’re within the strategy of dying being delivered to an ED, which in some instances can result in a extra traumatic dying than if the particular person remained within the house.
“As a result of nursing houses, at night-time particularly, and out-of-hours, can wrestle to get entry to main and palliative care, they are going to name an ambulance. And that affected person is introduced into the emergency division respiration their final, and dies inside just a few hours,” he added.
“It takes up lots of sources within the emergency division that contributes then to the ready time for different sufferers. And being shuttled out of your nursing house into the again of an ambulance will not be a dignified dying.”
Hospitals additionally face challenges in attempting to securely switch critically unwell sufferers as soon as they arrive within the ED.
“We would like sufferers, whether it is trying like they’re on a palliative trajectory, to have a single room,” he defined.
“Usually hospitals don’t have a single room to offer to those sufferers, otherwise you don’t need to transfer them down a hall or up the elevator to that single room, for concern of them dying en route.
“If a affected person is prone to die imminently, they’re not prone to go to the ICU both, so that they successfully have their care delivered within the emergency division. Nevertheless it’s not as we want it.”
In response, a HSE spokesperson pointed to the rising charges of sufferers going to an ED in recent times. Final 12 months there have been greater than 1.47 million new and return ED attendances, in comparison with simply over 1.36 million in 2019.
“Excessive degree knowledge out there on the variety of deaths in EDs does not distinguish between those that had been anticipated to die, those that suffered sudden catastrophic medical or surgical situations, those that had been victims of trauma or those that deteriorated unexpectedly within the ED,” the spokesperson stated.
“Because the variety of individuals residing in the neighborhood with continual life-limiting sickness will increase we anticipate to see larger numbers presenting in disaster to the ED, because the service that’s all the time out there and seen because the entry level to unscheduled care.”
