Patient physiological status during emergency care and rapid response team or cardiac arrest team activation during early hospital admission

Abstract

CAT/RRT activations within 72 h of emergency admission are associated with higher mortality and increased length of stay. Factors associated with CAT/RRT activation in the wards are often identifiable when patients are in the ED. Further studies are required to determine whether early identification and intervention in patients at risk for RRT or CAT activation can improve their eventual outcomes.

Patient physiological status at the emergency department–ward interface and emergency calls for clinical deterioration during early hospital admission

“…) and emergency calls in the early stages of hospital admission (Considine et al . , ). Predictors of hospital admission include systolic blood pressure ≤100 mmHg, pulse rate >130 beats per minute, respiratory rate >30 breaths per minute, temperature >38·5°C and altered conscious state (Burch et al .…”

“…Several studies have investigated the relationship between physiological status in ED and patient outcomes, such as hospital admission (Burch et al 2008), in-hospital death (Burch et al 2008, Groarke et al 2008) need for critical care admission (Groarke et al 2008) and emergency calls in the early stages of hospital admission (Considine et al 2015a(Considine et al , 2016a. Predictors of hospital admission include systolic blood pressure ≤100 mmHg, pulse rate >130 beats per minute, respiratory rate >30 breaths per minute, temperature >38Á5°C and altered conscious state (Burch et al 2008).…”

Emergency nurses’ decisions regarding frequency and nature of vital sign assessment

“…More recent research has shown that tachypnoea, tachycardia and hypotension [meeting hospital Rapid Response System (RRS) activation criteria] present in ED increase odds that a patient will require a RRS activation within the first 72 hours of their inpatient stay (Considine et al . in press). More participants nominated respiratory rate as needing reassessment (84·6%, n = 312/369) than oxygen saturation (76·4%, n = 282/369).…”

“…, Considine et al . in press). Vital sign assessment is a core emergency nursing responsibility (Curtis et al .…”

“…Recent Australian studies show that the most common cause of deterioration in ED patients is tachypnoea, tachycardia and hypotension (Considine et al . , , in press, Hosking et al . ).…”