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Early warning score

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https://www.readbyqxmd.com/read/28232377/using-quality-improvement-to-introduce-and-standardize-the-national-early-warning-score-news-for-adult-inpatients-at-a-children-s-hospital
#1
Erin E Conway-Habes, Brian F Herbst, Lori A Herbst, Benjamin Kinnear, Kristen Timmons, Deborah Horewitz, Rachel Falgout, Jennifer K O'Toole, Michael Vossmeyer
INTRODUCTION: The population of adults with childhood-onset chronic illness is growing across children's hospitals and constitutes a high risk population. National Early Warning Score (NEWS) is among the most recently validated adult early warning scores (EWSs) for early recognition of and response to clinical deterioration. Our aim was to implement and standardize NEWS scoring in 80% of patients age 21 and older admitted to a children's hospital. METHODS: Our intervention was tested on a single unit of our children's hospital...
February 23, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28230653/suicides-by-jumping-off-istanbul-bridges-linking-asia-and-europe
#2
Ayşe Yurtseven, İbrahim Üzün, Murat Nihat Arslan
AIM: The aim of this study was to determine the injury spectrum and characteristics of people who committed suicide by jumping into water from the July 15th Martyrs Bridge and Fatih Sultan Mehmet Bridges in Istanbul, Turkey. METHODS: This study included all of the jumpers from the July 15th Martyrs Bridge and Fatih Sultan Mehmet Bridge who were autopsied by the Council of Forensic Medicine, Istanbul Morgue Department, between 2000 and 2013. All of the data were collected from archived case files...
February 23, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28228342/evaluation-of-the-implementation-of-the-south-african-triage-system-at-an-academic-hospital-in-central-haiti
#3
Shada A Rouhani, Emily Aaronson, Angella Jacques, Sandy Brice, Regan H Marsh
BACKGROUND: Effective triage is an important part of high quality emergency care, yet is frequently lacking in resource-limited settings. The South African Triage Scale (SATS) is designed for these settings and consists of a numeric score (triage early warning score, TEWS) and a list of clinical signs (known as discriminators). Our objective was to evaluate the implementation of SATS at a new teaching hospital in Haiti. METHODS: A random sample of emergency department charts from October 2013 were retrospectively reviewed for the completeness and accuracy of the triage form, correct calculation of the triage score, and final patient disposition...
February 19, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28227035/visualizing-patient-journals-by-combining-vital-signs-monitoring-and-natural-language-processing
#4
Adnan Vilic, John Asger Petersen, Karsten Hoppe, Helge B D Sorensen, Adnan Vilic, John Asger Petersen, Karsten Hoppe, Helge B D Sorensen, John Asger Petersen, Adnan Vilic, Karsten Hoppe, Helge B D Sorensen
This paper presents a data-driven approach to graphically presenting text-based patient journals while still maintaining all textual information. The system first creates a timeline representation of a patients' physiological condition during an admission, which is assessed by electronically monitoring vital signs and then combining these into Early Warning Scores (EWS). Hereafter, techniques from Natural Language Processing (NLP) are applied on the existing patient journal to extract all entries. Finally, the two methods are combined into an interactive timeline featuring the ability to see drastic changes in the patients' health, and thereby enabling staff to see where in the journal critical events have taken place...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28182802/the-association-of-geriatric-syndromes-with-hospital-outcomes
#5
Roman Romero-Ortuno, Duncan R Forsyth, Kathryn Jane Wilson, Ewen Cameron, Stephen Wallis, Richard Biram, Victoria Keevil
BACKGROUND: Frailty, history of dementia (HoD), and acute confusional states (ACS) are common in older patients admitted to hospital. OBJECTIVE: To study the association of frailty (≥6 points in the Clinical Frailty Scale [CFS]), HoD, and ACS with hospital outcomes, controlling for age, gender, acute illness severity (measured by a Modified Early Warning Score in the emergency department), comorbidity (Charlson Comorbidity Index), and discharging specialty (general medicine, geriatric medicine, surgery)...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28151385/transfusion-associated-circulatory-overload-in-adult-medical-emergency-patients-with-perspectives-on-early-warning-practice-a-single-centre-clinical-study
#6
Fanny Gosmann, Astrid Nørgaard, Maj-Britt Rasmussen, Charlotte Rahbek, Jens Seeberg, Tom Møller
BACKGROUND: Transfusion-associated circulatory overload is characterised by acute respiratory distress, tachycardia, increased blood pressure, acute pulmonary oedema and/or evidence of positive fluid balance occurring within 6 hours after transfusion. Transfusion-associated circulatory overload is a serious, underreported reaction, which makes this iatrogenic condition difficult to prevent. We present an audit of patients admitted to a medical emergency unit, aiming to investigate: (i) the incidence of transfusion-associated circulatory overload; and (ii) whether cases were reported to the haemovigilance system...
January 26, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28149888/scoring-systems-for-the-characterization-of-sepsis-and-associated-outcomes
#7
COMMENT
Natalie McLymont, Guy W Glover
Sepsis is responsible for the utilisation of a significant proportion of healthcare resources and has high mortality rates. Early diagnosis and prompt interventions are associated with better outcomes but is impeded by a lack of diagnostic tools and the heterogeneous and enigmatic nature of sepsis. The recently updated definitions of sepsis have moved away from the centrality of inflammation and the systemic inflammatory response syndrome (SIRS) criteria which have been shown to be non-specific. Sepsis is now defined as a "life-threatening organ dysfunction caused by a dysregulated host response to infection"...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28110990/quick-sofa-scores-predict-mortality-in-adult-emergency-department-patients-with-and-without-suspected-infection
#8
Adam J Singer, Jennifer Ng, Henry C Thode, Rory Spiegel, Scott Weingart
STUDY OBJECTIVE: The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identify patients with infection who are at risk of complications. We determined the association between qSOFA scores and outcomes in adult emergency department (ED) patients with and without suspected infection. METHODS: We performed a single-site, retrospective review of adult ED patients between January 2014 and March 2015...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28081329/daily-surveillance-with-early-warning-scores-help-predicthospital-mortality-in-medical-wards
#9
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
#10
D Tirotta, M Gambacorta, M La Regina, T Attardo, A Lo Gullo, F Panzone, A Mazzone, M Campanini, F 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...
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
#11
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
#12
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...
February 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
#13
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
#14
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
#15
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
#16
(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
#17
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
#18
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
#19
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
#20
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
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