Division of Hyperacute Medicine

The Division of Hyperacute Medicine was established in 2001 to address the expanding role of emergency medicine in acute patient management. The Emergency-Acute Care Unit (E-ACU), which opened in January of 2001, is the flagship unit of this division. It is a 16-telemetry bed unit located on the sixth floor of the Hospital. It is staffed by a dedicated group of nurses, support associates, mid-level providers and physicians. The purpose of the unit is to provide the main ED with flexible space to care for patients requiring additional diagnostic or therapeutic services normally not offered or appropriate in an emergency department environment. Typical patients admitted to the E-ACU include patients with asthma, acutely decompensated heart failure, sickle cell vaso-occlusive crisis, cellulitis, pneumonia, abdominal pain, headache, gastroenteritis and electrolyte abnormalities.

The Cardiac Evaluation Unit (CEU) represents a certain population of patients within the E-ACU. These patients are thought to be at low to intermediate risk for exhibiting acute coronary syndrome at the time of presentation. Their risk is not negligible, however, and they are, therefore, admitted to the E-ACU under the CEU risk stratification protocol. These patients receive serial ECG and cardiac enzyme testing for a total of 9 hours, then undergo cardiac stress testing, usually using nuclear imaging or echocardiography, for further risk stratification.

Plans are underway to offer a fellowship intended to train physicians to develop and manage this kind of unit and to practice this branch or subspecialty of Emergency Medicine.