Table 2.
Severity of Illness Characteristics Associated with original “primary care treatable” diagnosesa and “non-emergency complaint” ED visitsb, NHAMCS 2009
| “Primary care treatable” diagnoses | “Non-emergency complaint” ED visits | |||||
|---|---|---|---|---|---|---|
| Unweighted No. c |
Weighted proportion, % |
(95% CI) | Unweighted No. c |
Weighted proportion, % |
(95% CI) | |
| Vital signsf | ||||||
| Respiratory Rate | ||||||
| Normal | 787 | 36.1 | (32.8–39.4) | 10,038 | 33.5 | (31.7–35.3) |
| Abnormal | 1,336 | 60.1 | (56.8–63.4) | 19,307 | 61.8 | (59.9–63.8) |
| Missing | 89 | 3.8 | (2.6–5.0) | 1,482 | 4.7 | (3.2–6.1) |
| Heart Rate | ||||||
| Normal d | 1,741 | 77.7 | (74.7–80.6) | 22,378 | 71.9 | (69.9–74.0) |
| Abnormal d | 343 | 16.1 | (14.0–18.3) | 6,605 | 21.8 | (20.8–22.8) |
| Missing | 128 | 6.2 | (3.3–9.0) | 1,844 | 6.2 | (3.8–8.7) |
| Blood Pressure | ||||||
| Normal d | 1,303 | 58.9 | (55.5–62.4) | 16,665 | 52.7 | (51.2–54.1) |
| Abnormal d | 642 | 28.5 | (25.6–31.5) | 10,302 | 34.2 | (32.7–35.8) |
| Missing | 267 | 12.6 | (10.3–14.8) | 3,858 | 13.1 | (11.3–14.9) |
| Pulse Oximetry | ||||||
| Normal | 1,769 | 78.8 | (74.5–83.2) | 24,337 | 77.5 | (74.1–81.1) |
| Abnormal | 76 | 3.7 | (1.9–5.5) | 1,904 | 6.6 | (5.3–7.9) |
| Missing | 367 | 17.5 | (13.3–21.7) | 4,586 | 15.9 | (12.5–19.3) |
| Temperature | ||||||
| Normal | 2,086 | 93.9 | (92.1–95.6) | 27,530 | 88.4 | (86.9–89.9) |
| Abnormal d | 47 | 2.0 | (1.3–2.6) | 1,745 | 6.1 | (5.5–6.7) |
| Missing | 79 | 4.2 | (2.4–6.0) | 1,552 | 5.5 | (4.0–7.0) |
| All vital signs | ||||||
| All normal | 285 | 12.6 | (10.5–14.7) | 3,265 | 10.4 | (9.5–11.2) |
| Any abnormal | 1,689 | 76.8 | (74.5–79.2) | 24,612 | 79.7 | (78.2–81.3) |
| All missing | 238 | 10.6 | (9.0–12.1) | 2,950 | 9.9 | (8.3–11.5) |
| Mode of arrival | ||||||
| Ambulance d | 116 | 5.8 | (4.3–7.2) | 4,289 | 13.8 | (12.8–14.8) |
| Other d | 1,975 | 88.5 | (86.2–90.8) | 25,000 | 81.2 | (80.0–82.5) |
| Missing/unknown | 121 | 5.8 | (4.3–7.2) | 1,538 | 5.0 | (3.8–6.2) |
| Pain scale | ||||||
| 0–5 | 802 | 34.8 | (30.7–38.8) | 11,906 | 38.0 | (35.7–40.3) |
| 6–10 | 899 | 41.3 | (37.6–45.0) | 11,623 | 38.0 | (35.9–40.1) |
| Missing | 511 | 23.9 | (19.6–28.2) | 7,298 | 24.0 | (20.6–27.4) |
Abbreviations: CI, confidence interval; NHAMCS, National Hospital Ambulatory Medical Care Survey; ED, emergency department
n=2,212 records, representing an estimated 8.5 million visits
n=30,827 records, representing an estimated 120.7 million visits
Number of records in the data set for each type of category (unweighted). Proportions, however, are calculated using survey weights.
Indicates significant difference between the visits with “primary care treatable” diagnoses and “non emergency complaint” ED visits
Normal vital signs were adjusted for age and are based on published values from Rosen’s Emergency Medicine (RR, HR) and from EMS guidelines (BP) below. Values that fell outside (above or below) these ranges were considered abnormal. Abnormal temperature was defined as a recorded temperature above 38°C/100.4° F
| Age | RR (breaths/min) |
HR | |
| <1 | 30–60 | 100–160 | BP, mmHg |
| 1–2 | 24–40 | 90–150 | Neonates (−1–28d) =60 SBP |
| 2–5 | 22–34 | 80–140 | Infants (1mo–1yr)=70–90 SBP |
| 6–12 | 18–30 | 70–120 | Children (1y–8y)=70–95 SBP |
| Adult | 12–16 | 60–100 | Adults= 90–140 SBP, 60–90 DBP |