Which of the following is NOT an acceptable reason for diversion?

• A. ED saturation
• B. ICU saturation
• C. Mass casualty incident
• D. ED closure to all incoming patients

Answer: (B)

Diversion decisions are made to ensure the ED can safely assess and treat incoming patients. The most appropriate reasons to divert are when the ED is overwhelmed (crowding), during a mass casualty incident to distribute the surge across facilities, or when the ED is closed to incoming patients. ICU saturation, however, is a downstream inpatient bed issue rather than an ED-capacity issue. An ED can still receive and begin to treat new patients even if ICU beds are full, arranging transfers or admissions as needed. Therefore ICU saturation is not an acceptable reason to divert.