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Original Research

Open Access Special Issue

Emergency department crowdedness and emergency department cardiac arrest occurrence: an observational study in the COVID-19 pandemic

  • Yan-Bo Huang1,†
  • Su-Yu Li2,†
  • Shang-Kai Hung1
  • Li-Heng Tsai1
  • Chip-Jin Ng1
  • Shou-Yen Chen1,3

1Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University, 333423 Taoyuan, Taiwan

2Department of Nursing, Chang Gung Memorial Hospital, 333423 Taoyuan, Taiwan

3Graduate Institute of Clinical Medical Sciences, Division of Medical Education, College of Medicine, Chang Gung University, 333323 Taoyuan, Taiwan

DOI: 10.22514/sv.2021.236

Submitted: 05 August 2021 Accepted: 25 October 2021

Online publish date: 18 November 2021

*Corresponding Author(s): Shou-Yen Chen E-mail:

† These authors contributed equally.


Emergency department (ED) crowdedness is a global phenomenon that can lead to many adverse effects. The relationship of crowdedness and emergency department cardiac arrest (EDCA) occurrence is still debated. The COVID-19 pandemic precipitated a change in the patient volume of the ED and the crowdedness of the ED varied with the epidemic in a continuous period. Different degrees of crowdedness provided us with an opportunity to study the relationship between crowdedness and EDCA occurrence. Our aim of this study was to determine the relationship between EDCA occurrence and prognosis and ED crowdedness.This was a longitudinal study conducted in a tertiary teaching hospital. The study period was from October 1, 2019, to September 30, 2020, and was divided into three periods according to daily patient volume and crowdedness. All nontraumatic and adult EDCA patients during the study period were included, and out-of-hospital cardiac arrest (OHCA) patients and patients with do-not-resuscitate orders were excluded.During the study period, a total of 126 EDCA patients were included. The ratio of EDCA events to daily patient volume was compared among these 3 periods, and there was no significant difference (P2: p = 0.109, P3: p = 0.761, P1 as reference). No significant difference in the prognosis of EDCA patients was found among the 3 periods, regardless of the return of spontaneous circulation (ROSC) (p = 0.437) or survival rates (p = 0.838). In conclusion, there was no obvious correlation between ED crowdedness and EDCA occurrence. The prognosis of EDCA patients was not significantly associated with crowdedness. The metrics of ED overcrowding is unknown and may need further study to develop a generally accepted standard or index.


EDCA; Cardiac arrest; Crowdedness; Overcrowding

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Yan-Bo Huang,Su-Yu Li,Shang-Kai Hung,Li-Heng Tsai,Chip-Jin Ng,Shou-Yen Chen. Emergency department crowdedness and emergency department cardiac arrest occurrence: an observational study in the COVID-19 pandemic. Signa Vitae. 2021.doi:10.22514/sv.2021.236.


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