Original Contributions FREESTANDING EMERGENCY DEPARTMENTS AND THE TRAUMA PATIENT Erin L. Simon, DO,* Kantha Medepalli, MD,† Carolyn J. Williams, MS,‡ Andrew Yocum, MD,† Eric Abrams, MD,† Gregory Griffin, BS,* and Kseniya Orlik, MD* *Department of Emergency Medicine, Akron General Medical Center, Akron, Ohio, †Northeast Ohio Medical University, Rootstown, Ohio, and ‡Department of Emergency Medicine Research, Akron General Medical Center, Akron, Ohio Reprint Address: Erin L. Simon, DO, Department of Emergency Medicine, Akron General Medical Center, 400 Wabash Avenue, Akron, OH 44307 , Abstract—Background: Freestanding emergency de- partments (FEDs) continue to grow in number and more research is needed on these facilities. Objective: We sought to characterize the types of injuries and patients who initially presented to two FEDs and were transferred to the main ter- tiary care ED for trauma team consult and admission. Methods: This retrospective cohort descriptive study exam- ined medical records of adult trauma patients who were initially seen at an FED and then transferred to the main ED. All patients who received a trauma consultation were included. Data collection included demographics, initial mode of transport to the ED, injury, mechanism of injury, ED, hospital course and outcome. Results: Mean age was 61.8 ± 23.8, 96.7% were Caucasian and 52.5% were male. Mode of transport to the FEDs included private vehicle (46.4%) and emergency medical services (53.6%). The main injury mechanisms were fall from standing (51.9%) and fall from an object (16%). A total of 12.7% were from motor vehicle accidents and 6.6% presented from bicycle and all-terrain vehicle accidents. Blunt traumatic injuries accounted for 97.8% (n = 177) patients. Computed tomogra- phy scanning was performed on 90.1% of patients. Median ED length of stay was 189 min. Mean hospital length of stay was 3 days and 2.2% (n = 4) of patients died from their injuries. Conclusions: Understanding the patients and trau- matic injuries that present to FEDs will guide training and identify resources needed for patients requiring additional care at a trauma center. Ó 2015 Elsevier Inc. , Keywords—trauma; freestanding emergency depart- ments; tertiary care INTRODUCTION The popularity of freestanding emergency departments (FEDs) is increasing. Earlier studies have demonstrated FED growth of up to 20% in 1 year and they continue to expand geographically (1). More than 400 FEDs are in operation, and the majority of them are affiliated with hospitals. Patients in need of emergency care are more likely to use the services of the nearest ED and, in some areas, these FEDs have helped ease the burden of overcrowded EDs (2–4). Even with the growth of these facilities, we were unable to locate earlier publications that studied traumatic injuries seen at FEDs and required additional care. We examined a population of trauma patients who presented to our FEDs and were subsequently transferred to the main tertiary care ED for a trauma consultation. Research involving FEDs has yet to evolve and the exact definition of FEDs remains obscure. Examining FED literature is difficult because facilities in the past provided varying levels of service. It was rare that a severe injury or illness presented to an FED in the 1980s. The results of one investigation conducted in the early 1980s found that critical ambulance traffic always bypassed the 15 FEDs being studied and noncritical ambulance transport patients were brought to only 1 facility (5). Most FEDs during the 1980s were known to treat only minor injuries and illness. RECEIVED: 7 March 2013; FINAL SUBMISSION RECEIVED: 9 May 2014; ACCEPTED: 2 September 2014 152 The Journal of Emergency Medicine, Vol. 48, No. 2, pp. 152–157, 2015 Copyright Ó 2015 Elsevier Inc. Printed in the USA. All rights reserved 0736-4679/$ - see front matter http://dx.doi.org/10.1016/j.jemermed.2014.09.005