Aims: Patients presenting to emergency departments (EDs) from cruise ships are a unique cohort of patients with several management challenges. Little evidence details the effect this has on EDs in terms of resource use. Therefore, we aimed to review the frequency, characteristics, admission, and intervention rates of cruise ship patient presentations to ED.
Methods: This retrospective study reviewed patient presentations to Wellington ED from cruise ships between 2016 and 2019. Data regarding presenting features, intervention and disposition were extracted via chart review.
Results: There were 214 patient presentations included with a median age of 68 (IQR 43.0-76.0); 97/214(45.3%) were female. Regarding referral, cruise ship doctors referred 79/214 (36.9%) patients; 16/79 (24.1%) to in-patient specialties and 63/79 (79.7%) to emergency medicine (EM); and 135/214 (63%) self-referred to ED. Common presenting complaints were chest pain, abdominal pain and trauma. Advanced imaging was requested for 21.5% of patients and 9.9% required urgent intervention. Regarding disposition, 38% were admitted (22% to in-patient wards, 16% to ED observation unit [OU]) and 61% were discharged (30% by ED and 31% after specialty consultation).
Conclusion: Overall, the number of cruise ship patients presenting to the ED was low and unlikely to be a significant resource burden. Referrals by cruise ship doctors were appropriate. Education for cruise ship patients and port services regarding non-emergent care options would be valuable to reduce self-referral rates.
© PMA.