Research Article

Use of the SONET Score to Evaluate High Volume Emergency Department Overcrowding: A Prospective Derivation and Validation Study

Table 6

General information on patients who were not initially identified as DNR and who ultimately died in hospital in the derivation study. There were a total of 4 patients that died within the study period. They were all transported via ambulance. NEDOCS and SONET scores were assigned to each patient at the time when they registered in the ED. Two of these four patients were registered in the ED during a time when the environment was considered severely overcrowded. However both patients were immediately seen by physicians and residents due to the severity of their illness. The average length of stay in the ED was 41 ± 11.6 minutes. Due to the limited number of patients, our results showed no association between ED crowding and mortality.

Patient numberChief complaintMOAED LOSTotal LOHNEDOCS scoreSONET score

1Cardiac arrestEMS25 min 8 h, 20 minOvercrowded
(103)
Not overcrowded
(67)

2Acute respiratory distressEMS40 min6 daysSeverely overcrowded
(142)
Severely overcrowded
(144)

3Acute respiratory distressEMS48 min15 h, 58 mNot overcrowded
(85)
Not overcrowded
(80)

4Transfer: gunshot wound to the headEMS51 min10 h, 48 mSeverely overcrowded
(143)
Severely overcrowded
(160)

MOA: mode of arrival; LOS: length of stay; LOH: length of hospitalization.
The numbers in these two columns stand for the ED crowding score using either NEDOCS or SONET scoring system at the time the individual patient was registered at ED.