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National Early Warning Score

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https://www.readbyqxmd.com/read/29775642/national-early-warning-score-news-in-a-finnish-multidisciplinary-emergency-department-and-direct-vs-late-admission-to-intensive-care
#1
Mikko Kivipuro, Joonas Tirkkonen, Timo Kontula, Juuso Solin, Jari Kalliomäki, Satu-Liisa Pauniaho, Heini Huhtala, Arvi Yli-Hankala, Sanna Hoppu
OBJECTIVES: We investigated the national early warning scores (NEWSs) and related outcomes of patients in a tertiary referral center's multidisciplinary emergency department (ED). Patients were further categorized into three groups: triaged directly to intensive care unit (EDICU), triaged to general ward with later ICU admission (EDwardICU) and triaged to general ward (EDward). NEWSs and subsequent outcomes among these sub groups were compared. METHODS: We conducted a prospective one-month cohort study in Tampere University Hospital's ED, Finland...
May 15, 2018: Resuscitation
https://www.readbyqxmd.com/read/29735507/a-severe-deep-neck-odontogenic-infection-not-prioritised-by-the-emergency-department-triage-system-and-national-early-warning-score
#2
Emma Wates, James Higginson, Andre Kichenaradjou, Kieron McVeigh
A 62-year-old man with a background of type 2 diabetes mellitus presented to the emergency department (ED) with a 5-day history of dental pain, progressive right facial swelling, trismus, dysphagia and voice changes. The oropharynx could not be directly examined completely due to trismus. The patient had a National Early Warning Score of 0 and so was triaged into the 'minors' section of ED. Following assessment by the on-call oral and maxillofacial surgeon, an urgent contrast-enhanced CT demonstrated a large parapharyngeal collection, which required urgent anaesthetic and surgical intervention...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29719875/using-an-original-triage-and-on-call-management-tool-aids-identification-and-assessment-of-the-acutely-unwell-surgical-patient
#3
Stacie Hodge, Sebastian Helliar, Hamish Ian Macdonald, Paul Mackey
Until now, there have been no published surgical triage tools. We have developed the first such tool with a tiered escalation policy, aiming to improve identification and management of critically unwell patients. The existing sheet which is used to track new referrals and admissions to the surgical assessment unit was reviewed. The sheet was updated and a traffic light triage tool generated using National Early Warning Scores (NEWS), sepsis criteria and user discretion. A tiered escalation policy to guide urgency of assessment was introduced and education sessions for all staff undertaken, to ensure understanding and compliance...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29719873/ward-round-template-enhancing-patient-safety-on-ward-rounds
#4
Niall Gilliland, Natalie Catherwood, Shaouyn Chen, Peter Browne, Jacob Wilson, Helena Burden
Introduction and aims: Concerns had been raised at clinical governance regarding the safety of our inpatient ward rounds with particular reference to: documentation of clinical observations and National Early Warning Score (NEWS), compliance with Trust guidance for venous thromboembolism (VTE) risk assessment, antibiotic stewardship, palliative care and treatment escalation plans (TEP). This quality improvement project was conceived to ensure these parameters were considered and documented during the ward round, thereby improving patient care and safety...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29626015/the-prediction-of-in-hospital-mortality-by-mid-upper-arm-circumference-a-prospective-observational-study-of-the-association-between-mid-upper-arm-circumference-and-the-outcome-of-acutely-ill-medical-patients-admitted-to-a-resource-poor-hospital-in-sub-saharan
#5
Martin Otyek Opio, Teopista Namujwiga, Imaculate Nakitende, John Kellett, Mikkel Brabrand
There are few reports of the association of nutritional status with in-hospital mortality of acutely ill medical patients in sub-Saharan Africa. This is a prospective observational study comparing the predictive value of mid-upper arm circumference (MUAC) of 899 acutely ill medical patients admitted to a resource-poor sub-Saharan hospital with mental alertness, mobility and vital signs. Mid-upper arm circumference ranged from 15 cm to 42 cm, and 12 (24%) of the 50 patients with a MUAC less than 20 cm died (OR 4...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29625600/implementing-paediatric-early-warning-scores-systems-in-the-netherlands-future-implications
#6
J F de Groot, N Damen, E de Loos, L van de Steeg, L Koopmans, P Rosias, M Bruijn, J Goorhuis, C Wagner
BACKGROUND: Paediatric Early Warning Scores (PEWS) are increasingly being used for early identification and management of clinical deterioration in paediatric patients. A PEWS system includes scores, cut-off points and appropriate early intervention. In 2011, The Dutch Ministry of Health advised hospitals to implement a PEWS system in order to improve patient safety in paediatric wards. The objective of this study was to examine the results of implementation of PEWS systems and to gain insight into the attitudes of professionals towards using a PEWS system in Dutch non-university hospitals...
April 6, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29578879/what-faces-reveal-a-novel-method-to-identify-patients-at-risk-of-deterioration-using-facial-expressions
#7
Maria Isabel Madrigal-Garcia, Marcos Rodrigues, Alex Shenfield, Mervyn Singer, Jeronimo Moreno-Cuesta
OBJECTIVES: To identify facial expressions occurring in patients at risk of deterioration in hospital wards. DESIGN: Prospective observational feasibility study. SETTING: General ward patients in a London Community Hospital, United Kingdom. PATIENTS: Thirty-four patients at risk of clinical deterioration. INTERVENTIONS: A 5-minute video (25 frames/s; 7,500 images) was recorded, encrypted, and subsequently analyzed for action units by a trained facial action coding system psychologist blinded to outcome...
March 23, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29541854/curb-65-score-is-equal-to-news-for-identifying-mortality-risk-of-pneumonia-patients-an-observational-study
#8
Mikkel Brabrand, Daniel Pilsgaard Henriksen
IMPORTANCE: The CURB-65 score is widely implemented as a prediction tool for identifying patients with community-acquired pneumonia (cap) at increased risk of 30-day mortality. However, since most ingredients of CURB-65 are used as general prediction tools, it is likely that other prediction tools, e.g. the British National Early Warning Score (NEWS), could be as good as CURB-65 at predicting the fate of CAP patients. OBJECTIVE: To determine whether NEWS is better than CURB-65 at predicting 30-day mortality of CAP patients...
June 2018: Lung
https://www.readbyqxmd.com/read/29522831/in-hospital-cardiac-arrest-after-a-rapid-response-team-review-a-matched-case-control-study
#9
Joonas Tirkkonen, Heini Huhtala, Sanna Hoppu
AIM: Study the incidence and reasons behind in-hospital cardiac arrests (IHCAs) after rapid response team (RRT) reviews. METHODS: We conducted a matched case-control study at Tampere University Hospital, Finland. Data on adult patients who were triaged to remain on general ward after first (index) RRT review without treatment limitations but who suffered an IHCA within the following 48 h were prospectively collected for 5.3 years. These cases were matched (age ±3 years, sex, surgical/medical ward, admission year) at a 1:4 ratio to controls (no ICHA after RRT review)...
May 2018: Resuscitation
https://www.readbyqxmd.com/read/29517318/updating-the-national-early-warning-score-algorithm-saving-more-lives
#10
Alan Glasper
Emeritus Professor Alan Glasper, University of Southampton, discusses the contribution of the Royal College of Physicians to effective monitoring of sick patients in hospital.
March 8, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29512139/should-impaired-mobility-on-presentation-be-a-vital-sign
#11
M Brabrand, J Kellett, M Opio, T Cooksley, C H Nickel
INTRODUCTION: Vital signs are routinely used to assess acutely ill patients, but they do not detect all patients at risk of death. This retrospective multicenter cohort study compares the prediction of death by impaired mobility with age, co-morbidities, and vital sign changes. METHODS: On first assessment, patients from a combined cohort of 9684 Danish and Irish patients and a separate cohort of 1010 Ugandan patients were stratified by impaired mobility on presentation (IMOP), vital sign changes assessed by the National Early Warning Score (NEWS), the Charlson Co-morbidity Index, and age...
March 6, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29511537/pre-hospital-national-early-warning-score-news-is-associated-with-in-hospital-mortality-and-critical-care-unit-admission-a-cohort-study
#12
Tom E F Abbott, Nicholas Cron, Nidhi Vaid, Dorothy Ip, Hew D T Torrance, Julian Emmanuel
Background: National Early Warning Score (NEWS) is increasingly used in UK hospitals. However, there is only limited evidence to support the use of pre-hospital early warning scores. We hypothesised that pre-hospital NEWS was associated with death or critical care escalation within the first 48 h of hospital stay. Methods: Planned secondary analysis of a prospective cohort study at a single UK teaching hospital. Consecutive medical ward admissions over a 20-day period were included in the study...
March 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29467173/qsofa-sirs-and-news-for-predicting-inhospital-mortality-and-icu-admission-in-emergency-admissions-treated-as-sepsis
#13
Robert Goulden, Marie-Claire Hoyle, Jessie Monis, Darran Railton, Victoria Riley, Paul Martin, Reynaldo Martina, Emmanuel Nsutebu
BACKGROUND: The third international consensus definition for sepsis recommended use of a new prognostic tool, the quick Sequential Organ Failure Assessment (qSOFA), based on its ability to predict inhospital mortality and prolonged intensive care unit (ICU) stay in patients with suspected infection. While several studies have compared the prognostic accuracy of qSOFA to the Systemic Inflammatory Response Syndrome (SIRS) criteria in suspected sepsis, few have compared qSOFA and SIRS to the widely used National Early Warning Score (NEWS)...
February 21, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29436439/the-national-early-warning-score-and-its-subcomponents-recorded-within-%C3%A2-24-h-of-emergency-medical-admission-are-poor-predictors-of-hospital-acquired-acute-kidney-injury
#14
Muhammad Faisal, Andy Scally, Musab Ahmed Elgaali, Donald Richardson, Kevin Beatson, Mohammed A Mohammed
Hospital-acquired acute kidney injury (H-AKI) is a common cause of avoidable morbidity and mortality. Therefore , in the current study, we investigated whether vital signs data from patients, as defined by a National Early Warning Score (NEWS), can predict H-AKI following emergency admission to hospital. We analysed all emergency admissions (n=33,608) to York Hospital with NEWS data over a 24-month period. Here, we report the area under the curve (AUC) for logistic regression models that used the index NEWS (model A0), plus age and sex (A1), plus subcomponents of NEWS (A2) and two-way interactions (A3), and similarly for maximum NEWS (models B0,B1,B2,B3)...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29334564/validating-the-electronic-cardiac-arrest-risk-triage-ecart-score-for-risk-stratification-of-surgical-inpatients-in-the-postoperative-setting-retrospective-cohort-study
#15
Bartlomiej Bartkowiak, Ashley M Snyder, Andrew Benjamin, Andrew Schneider, Nicole M Twu, Matthew M Churpek, Kevin K Roggin, Dana P Edelson
OBJECTIVE: Assess the accuracy of 3 early warning scores for predicting severe adverse events in postoperative inpatients. SUMMARY OF BACKGROUND DATA: Postoperative clinical deterioration on inpatient hospital services is associated with increased morbidity, mortality, and cost. Early warning scores have been developed to detect inpatient clinical deterioration and trigger rapid response activation, but knowledge regarding the application of early warning scores to postoperative inpatients is limited...
January 12, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29277622/national-early-warning-score-accurately-discriminates-the-risk-of-serious-adverse-events-in-patients-with-liver-disease
#16
Theresa J Hydes, Paul Meredith, Paul E Schmidt, Gary B Smith, David R Prytherch, Richard J Aspinall
BACKGROUND & AIMS: The National Early Warning Score (NEWS) is used to identify deteriorating adult hospital inpatients. However, it includes physiological parameters frequently altered in patients with cirrhosis. We aimed to assess the performance of the NEWS in acute and chronic liver diseases. METHODS: We collected vital signs, recorded in real time, from completed consecutive admissions of patients 16 years or older to a large acute-care hospital in Southern England, from January 1, 2010, through October 31, 2014...
December 24, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29248587/enhanced-case-management-can-be-delivered-for-patients-with-evd-in-africa-experience-from-a-uk-military-ebola-treatment-centre-in-sierra-leone
#17
S J Dickson, K A Clay, M Adam, C Ardley, M S Bailey, D S Burns, A T Cox, D G Craig, M Espina, I Ewington, G Fitchett, J Grindrod, D E Hinsley, S Horne, E Hutley, A M Johnston, R L C Kao, L E Lamb, S Lewis, D Marion, A J Moore, T C Nicholson-Roberts, A Phillips, J Praught, P S Rees, I Schoonbaert, T Trinick, D R Wilson, A J Simpson, D Wang, M K O'Shea, T E Fletcher
BACKGROUND: Limited data exist describing supportive care management, laboratory abnormalities and outcomes in patients with Ebola virus disease (EVD) in West Africa. We report data which constitute the first description of the provision of enhanced EVD case management protocols in a West African setting. METHODS: Demographic, clinical and laboratory data were collected by retrospective review of clinical and laboratory records of patients with confirmed EVD admitted between 5 November 2014 and 30 June 2015...
December 14, 2017: Journal of Infection
https://www.readbyqxmd.com/read/29242109/short-national-early-warning-score-developing-a-modified-early-warning-score
#18
Leandro Luís, Carla Nunes
INTRODUCTION: Early Warning Score (EWS) systems have been developed for detecting hospital patients clinical deterioration. Many studies show that a National Early Warning Score (NEWS) performs well in discriminating survival from death in acute medical and surgical hospital wards. NEWS is validated for Portugal and is available for use. A simpler EWS system may help to reduce the risk of error, as well as increase clinician compliance with the tool. OBJECTIVES: The aim of the study was to evaluate whether a simplified NEWS model will improve use and data collection...
December 11, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29229436/a-longitudinal-analysis-of-allostatic-load-among-a-multi-ethnic-sample-of-midlife-women-findings-from-the-study-of-women-s-health-across-the-nation
#19
Laura Chyu, Dawn M Upchurch
OBJECTIVES: We examined longitudinal patterns and sociodemographic correlates of allostatic load (AL), a measure of cumulative biological risk and aging, in a sample of midlife women consisting of non-Hispanic White, African American, Chinese, and Japanese women. METHODS: Longitudinal cohort data from the Study of Women's Health Across the Nation were used to examine AL patterns in midlife women ages 42-53 (n = 1,932). AL measures were created using 10 biomarkers representing cardiovascular, inflammatory, neuroendocrine, and metabolic system functioning...
December 8, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29216942/-comparison-of-national-early-warning-score-rapid-emergency-medicine-score-and-acute-physiology-and-chronic-health-evaluation-ii-score-for-predicting-outcome-among-emergency-severe-patients
#20
Li Chen, Lipu Deng, Hongmei Zhao, Xiaoying Huang, Xianghua He, Xiangmin Li, Ben Liu, Yongxiang Xie
OBJECTIVE: To analyze the comparation of national early warning score (NEWS), rapid emergency medicine score (REMS) and acute physiology and chronic health evaluation II (APACHE II) score in predicting prognosis of critically ill patients in emergency department (ED). METHODS: A retrospective study was conducted. Critically ill patients, aged > 16 years, hospitalized > 24 hours, and admitted to the ED of Nanhua Hospital Affiliated to South China University from January 2016 to June 2017 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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