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Early warning score

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https://www.readbyqxmd.com/read/28081329/daily-surveillance-with-early-warning-scores-help-predicthospital-mortality-in-medical-wards
#1
Mine Durusu Tanrıöver, Burçin Halaçlı, Bilgin Sait, Serpil Öcal, Arzu Topeli
BACKGROUND/AIM: To analyze the potency of a modified early warning score (EWS) to help predict hospital mortality when used for surveillance in nonacute medical wards. MATERIALS AND METHODS: Patients in internal medicine wards were prospectively recruited. First, highest, and last scores; and mean daily score recordings and values were recorded. Nurses calculated scores for each patient upon admission and every 4 h. The last score was the score before death, discharge, or transfer to another ward...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28069905/evaluation-of-the-threshold-value-for-the-modified-early-warning-score-mews-in-medical-septic-patients-a-secondary-analysis-of-an-italian-multicentric-prospective-cohort-snoopii-study
#2
Daniela Tirotta, Maurizia Gambacorta, La Regina Micaela, Tiziana Attardo, Lo Gullo Alberto, Filomena Panzone, Mazzone Antonino, Campanini Mauro, Francesco Dentali
BACKGROUND: Due to aging and resources limitation, septic patients are often admitted to medical wards (MWs). Early warning deterioration is a relevant issue in this setting. Unfortunately, a suitable prognostic score has not been identified, yet. AIM: To explore the ability of Modified Early Warning Score (MEWS) to predict the in-hospital mortality in septic patients admitted to MWs. DESIGN SECONDARY ANALYSIS OF A MULTICENTRIC PROSPECTIVE STUDY: Methods: Consecutive septic patients with positive blood culture admitted to 31 Italian MWs were included...
January 9, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28065966/implementation-of-warning-tool-to-improve-maternal-newborn-health-outcomes-in-a-developing-country
#3
Sana Sheikh, Rahat Qureshi, Sidrah Nausheen, Rozina Sikandar
OBJECTIVE: To improve health outcomes through the implementation of national early warning sign tool for babies delivered through emergency caesarean section in off-work hours. METHODS: This comparative clinical study was conducted at the Aga Khan Hospital for Women and Children, Karachi, from April to August 2014, and comprised women who had an emergency caesarean section. Maternal and perinatal outcomes were compared of patients in Group A and Group B which represented individuals before and after the implementation of the national early warning score respectively...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28052686/henoch-sch%C3%A3-nlein-purpura-as-a-rare-cause-of-an-acute-abdomen
#4
M Davies, M Nanda Kumar, V Shetty, P Mitchell
A 52-year-old man presented with a purpuric rash affecting his legs and hypertension. He was diagnosed with Henoch-Schönlein purpura and discharged with non-steroidal anti-inflammatory drugs. Three weeks later, he presented again with loss of appetite and vomiting before developing abdominal pain with pyrexia of 38.5°C and rigors. On examination, he was hypotensive with a distended abdomen and a national early warning score of 6. Computed tomography revealed enteropathy of Henoch-Schönlein purpura. The patient deteriorated and went for an emergency laparotomy, where 30cm of ischaemic small bowel was resected...
January 4, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27997586/determination-of-normal-ranges-of-shock-index-and-other-haemodynamic-variables-in-the-immediate-postpartum-period-a-cohort-study
#5
Hannah L Nathan, Kate Cottam, Natasha L Hezelgrave, Paul T Seed, Annette Briley, Susan Bewley, Lucy C Chappell, Andrew H Shennan
OBJECTIVE: To determine the normal ranges of vital signs, including blood pressure (BP), mean arterial pressure (MAP), heart rate (HR) and shock index (SI) (HR/systolic BP), in the immediate postpartum period to inform the development of robust obstetric early warning scores. STUDY DESIGN: We conducted a secondary analysis of a prospective observational cohort study evaluating vital signs collected within one hour following delivery in women with estimated blood loss (EBL) <500ml (316 women) delivering at a UK tertiary centre over a one-year period...
2016: PloS One
https://www.readbyqxmd.com/read/27995409/the-hydra-regeneration-assay-reveals-ecological-risks-in-running-waters-a-new-proposal-to-detect-environmental-teratogenic-threats
#6
Lorenzo Traversetti, Floriano Del Grosso, Valentina Malafoglia, Marco Colasanti, Simona Ceschin, Stefano Larsen, Massimiliano Scalici
The regenerative ability of Hydra vulgaris was tested as potential biomarker for the development of a new eco-toxicological index. The test is based on the regeneration rate and the aberration frequency of the columna (body and adhesive foot) after separation from head and tentacles by a bistoury. Particularly, 45 columnae were submerged in the rearing solution (that is Hydra medium) to have control, and 285 in potential contaminated waters to have treatments, collected from 19 sites along 10 rivers in central Italy...
December 19, 2016: Ecotoxicology
https://www.readbyqxmd.com/read/27959834/simplifying-ehr-overview-of-critically-ill-patients-through-vital-signs-monitoring
#7
Adnan Vilic, Karsten Hoppe, John Petersen, Troels Kjaer, Helge Sorensen
This paper presents a novel data-driven approach to graphical presentation of text-based electronic health records (EHR) while maintaining all textual information. We have developed the Patient Condition Timeline (PCT) tool, which creates a timeline representation of a patients' physiological condition during admission. PCT is based on electronical monitoring of vital signs and then combining these into Early Warning Scores (EWS). Hereafter, techniques from Natural Language Processing (NLP) are applied on existing EHR to extract all entries...
December 9, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/27923314/value-of-early-warning-scores-in-emergency-departments
#8
(no author information available yet)
Developed in the belief that early identification and intervention of deteriorating patients would reduce the number of deaths, early warning scores (EWS) have become a routine feature of work in UK emergency departments (EDs) and are becoming increasingly common in paediatric emergency care. They are popular with managers, commissioners and clinicians, yet the authors of this report state that there is little evidence of this reduction in the literature.
December 7, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27912778/medical-priority-dispatch-codes-comparison-with-national-early-warning-score
#9
Marko Hoikka, Sami Länkimäki, Tom Silfvast, Tero I Ala-Kokko
BACKGROUND: In Finland, calls for emergency medical services are prioritized by educated non-medical personnel into four categories-from A (highest risk) to D (lowest risk)-following a criteria-based national dispatch protocol. Discrepancies in triage may result in risk overestimation, leading to inappropriate use of emergency medical services units and to risk underestimation that can negatively impact patient outcome. To evaluate dispatch protocol accuracy, we assessed association between priority assigned at dispatch and the patient's condition assessed by emergency medical services on the scene using an early warning risk assessment tool...
December 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27907062/sepsis-prevalence-and-outcome-on-the-general-wards-and-emergency-departments-in-wales-results-of-a-multi-centre-observational-point-prevalence-study
#10
Tamas Szakmany, Robert M Lundin, Ben Sharif, Gemma Ellis, Paul Morgan, Maja Kopczynska, Amrit Dhadda, Charlotte Mann, Danielle Donoghue, Sarah Rollason, Emma Brownlow, Francesca Hill, Grace Carr, Hannah Turley, James Hassall, James Lloyd, Llywela Davies, Michael Atkinson, Molly Jones, Nerys Jones, Rhodri Martin, Yousef Ibrahim, Judith E Hall
Data on sepsis prevalence on the general wards is lacking on the UK and in the developed world. We conducted a multicentre, prospective, observational study of the prevalence of patients with sepsis or severe sepsis on the general wards and Emergency Departments (ED) in Wales. During the 24-hour study period all patients with NEWS≥3 were screened for presence of 2 or more SIRS criteria. To be eligible for inclusion, patients had to have a high clinical suspicion of an infection, together with a systemic inflammatory response (sepsis) and evidence of acute organ dysfunction and/or shock (severe sepsis)...
2016: PloS One
https://www.readbyqxmd.com/read/27875727/predictor-of-left-ventricular-dysfunction-after-aortic-valve-replacement-in-mixed-aortic-valve-disease
#11
Alexander C Egbe, Carole A Warnes
BACKGROUND: The fate of the left ventricle (LV) after aortic valve replacement (AVR) in mixed aortic valve disease (MAVD) is unknown. METHODS: Patients with moderate-severe MAVD, ejection fraction ≥50%, and no coronary artery disease who underwent AVR were identified. Moderate-severe MAVD was defined as a combination of ≥moderate aortic stenosis and ≥moderate aortic regurgitation. Assessment for LVD was performed at 1 and 5years after AVR. The purpose of the study was to determine prevalence and predictors of early and late left ventricular dysfunction (LVD) defined as ejection fraction <50% at 1 and 5years post-AVR...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27868189/an-evaluation-of-inpatient-morbidity-and-critical-care-provision-in-zambia
#12
P J Dart, J Kinnear, M D Bould, S L Mwansa, Z Rakhda, D Snell
The aim of this study was to objectively measure demand for critical care services in a southern African tertiary referral centre. We carried out a point prevalence study of medical and surgical admissions over a 48-h period at the University Teaching Hospital, Lusaka, recording the following: age; sex; diagnosis; Human Immunodeficiency Virus (HIV) status and National Early Warning Score. One-hundred and twenty medical and surgical admissions were studied. Fifty-four patients (45%) had objective evidence of a requirement for critical care review and potential or probable admission to an intensive care unit, according to the Royal College of Physicians (UK) guidelines...
November 21, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27865003/capturing-early-signs-of-deterioration-the-dutch-early-nurse-worry-indicator-score-denwis-and-its-value-in-the-rapid-response-system
#13
Gooske Douw, Getty Huisman-de Waal, Arthur R H van Zanten, Johannes G van der Hoeven, Lisette Schoonhoven
OBJECTIVES: To determine the predictive value of individual and combined DENWIS-indicators at various Early-Warning-Score (EWS)-levels, differentiating between EWSs reaching the trigger-threshold to call an RRT and EWS-levels not reaching this point. INTRODUCTION: DENWIS comprises nine indicators underlying nurses' 'worry' about a patients' condition. All indicators independently show significant association with unplanned Intensive-Care/High-Dependency-Unit (ICU/HDU)-admission or unexpected mortality...
November 16, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27863876/scoping-review-the-use-of-early-warning-systems-for-the-identification-of-in-hospital-patients-at-risk-of-deterioration
#14
REVIEW
Marie Danielle Le Lagadec, Trudy Dwyer
INTRODUCTION: Early warning systems (EWS) were developed as a means of alerting medical staff to patient clinical decline. Since 85% of severe adverse events are preceded by abnormal physiological signs, the patient bed-side vital signs observation chart has emerged as an EWS tool to help staff identify and quantify deteriorating patients. There are three broad categories of patient observation chart EWS: single or multiple parameter systems; aggregated weighted scoring systems; or combinations of single or multiple parameter and aggregated weighted scoring systems...
November 15, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27858814/moving-beyond-single-parameter-early-warning-scores-for-rapid-response-system-activation
#15
Matthew M Churpek, Dana P Edelson
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850864/1228-does-a-multiparameter-early-warning-scoring-system-predict-clinical-deterioration
#16
Jill Williams, Ellie Olson, James Kelly
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850827/1191-validation-of-a-pediatric-early-warning-score-in-a-pediatric-oncology-hospital-in-guatemala
#17
Asya Agulnik, Alejandra Mendez, Lupe Mora, Peter Forbes, Dora Soberanis, Ricardo Mack, Monica Kleinman, Carlos Rodriguez-Galindo
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27832561/improved-hospital-mortality-with-a-low-met-dose-the-importance-of-a-modified-early-warning-score-and-communication-tool
#18
D V Mullany, M Ziegenfuss, M A Goleby, H E Ward
Rapid response systems have been mandated for the recognition and management of the deteriorating patient. Increasing medical emergency team (MET) dose may be associated with improved outcomes. Large numbers of MET calls may divert resources from the program providing the service unless additional personnel are provided. To describe the implementation and outcomes of a multifaceted rapid response system (RRS) in a teaching hospital, we conducted an observational study. The RRS consisted of the introduction of a MET together with 1) redesign of the ward observation chart with the vital sign variables colour-coded to identify variation from normal; 2) mandated minimum frequency of vital sign measurement; 3) three formal levels of escalation based on the degree of physiological instability as measured by a modified early warning score (MEWS); 4) COMPASS© education and e-learning package with a two-hour face-to-face small group tutorial; 5) practise in escalation and communication using the ISBAR (Identify, Situation, Background, Assessment, Response/Recommendation) communication tool...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27832032/accuracy-and-efficiency-of-recording-pediatric-early-warning-scores-using-an-electronic-physiological-surveillance-system-compared-with-traditional-paper-based-documentation
#19
Gerri Sefton, Steven Lane, Roger Killen, Stuart Black, Max Lyon, Pearl Ampah, Cathryn Sproule, Dominic Loren-Gosling, Caitlin Richards, Jean Spinty, Colette Holloway, Coral Davies, April Wilson, Chung Shen Chean, Bernie Carter, E D Carrol
Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined "norm." Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score...
November 9, 2016: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/27823915/validation-of-the-children-s-hospital-early-warning-system-for-critical-deterioration-recognition
#20
Mary C McLellan, Kimberlee Gauvreau, Jean Anne Connor
OBJECTIVE: Early warning scores, such as the Children's Hospital Early Warning Score (CHEWS), are used by hospitals to identify patients at risk for critical deterioration and trigger clinicians to intervene and prevent further deterioration. This study's objectives were to validate the CHEWS and to compare the CHEWS to the previously validated Brighton Pediatric Early Warning Score (PEWS) for early detection of critical deterioration in hospitalized, non-cardiac patients at a pediatric hospital...
November 4, 2016: Journal of Pediatric Nursing
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