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Modified Early Warning System

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https://www.readbyqxmd.com/read/27832564/defining-a-reference-range-for-vital-signs-in-healthy-term-pregnant-women-undergoing-caesarean-section
#1
A Dennis, L Hardy
Early warning systems (EWS), used to identify deteriorating hospitalised patients, are based on measurement of vital signs. When the patients are pregnant, most EWS still use non-pregnant reference ranges of vital signs to determine trigger thresholds. There are no published reference ranges for all vital signs in pregnancy. We aimed to define vital signs reference ranges for term pregnancy in the preoperative period, and to determine the appropriateness of EWS trigger criteria in pregnancy. We conducted a one-year retrospective study in a tertiary referral obstetric hospital...
November 2016: Anaesthesia and Intensive Care
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
#2
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/27811448/the-comparison-of-modified-early-warning-score-and-glasgow-coma-scale-age-systolic-blood-pressure-scores-in-the-assessment-of-nontraumatic-critical-patients-in-emergency-department
#3
Ö Köksal, G Torun, E Ahun, D Sığırlı, S B Güney, M O Aydın
INTRODUCTION: The purpose of this study is to assess and compare the discriminatory ability of the Glasgow coma scale (GCS)-age-systolic blood pressure (GAP) score and modified early warning scoring system (mEWS) score for 4-week mortality, for the patients being in the triage category 1 and 2 who refer to Emergency Department (ED). METHODS: Five hundred and two nontraumatic cases being in the triage category 1 and 2 who were ≥18-year-old and who referred to ED were assessed prospectively...
November 2016: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/27804076/the-predictive-value-of-the-modified-early-warning-score-with-rapid-lactate-level-views-l-for-mortality-in-patients-of-age-65-or-older-visiting-the-emergency-department
#4
Hasan Basri Cetınkaya, Ozlem Koksal, Deniz Sigirli, Emrah Habip Leylek, Ozlem Karasu
The purpose of this study is to detect the predictive power of the modified early warning score with rapid lactate level (ViEWS-L) on mortality in critical patients over the age of 65 years admitted to the emergency department (ED). A total of 616 non-traumatic patients admitted to the Uludag University Faculty of Medicine ED who were 65 years of age or older were included in this study (Ethics board number: 2015-4/8). In this prospective study; the ViEWS-L score of the patients were calculated. The results have been evaluated with rate of mortality in the first 24 h starting from submission...
November 1, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27783733/modified-early-warning-score-evaluation-of-trauma-patients
#5
Thaís Flôr da Rocha, Juliana Gibbon Neves, Karin Viegas
Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48...
September 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27766526/implementation-of-a-novel-postoperative-monitoring-system-using-automated-modified-early-warning-scores-mews-incorporating-end-tidal-capnography
#6
Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27694098/prediction-of-sepsis-in-the-intensive-care-unit-with-minimal-electronic-health-record-data-a-machine-learning-approach
#7
Thomas Desautels, Jacob Calvert, Jana Hoffman, Melissa Jay, Yaniv Kerem, Lisa Shieh, David Shimabukuro, Uli Chettipally, Mitchell D Feldman, Chris Barton, David J Wales, Ritankar Das
BACKGROUND: Sepsis is one of the leading causes of mortality in hospitalized patients. Despite this fact, a reliable means of predicting sepsis onset remains elusive. Early and accurate sepsis onset predictions could allow more aggressive and targeted therapy while maintaining antimicrobial stewardship. Existing detection methods suffer from low performance and often require time-consuming laboratory test results. OBJECTIVE: To study and validate a sepsis prediction method, InSight, for the new Sepsis-3 definitions in retrospective data, make predictions using a minimal set of variables from within the electronic health record data, compare the performance of this approach with existing scoring systems, and investigate the effects of data sparsity on InSight performance...
September 30, 2016: JMIR Medical Informatics
https://www.readbyqxmd.com/read/27686826/a-modified-delphi-study-to-identify-factors-associated-with-clinical-deterioration-in-hospitalized-children
#8
Kristina Krmpotic, Ann Van den Bruel, Anna-Theresa Lobos
OBJECTIVE: Hospitalized children who are admitted to the inpatient ward can deteriorate and require unplanned transfer to the PICU. Studies designed to validate early warning scoring systems have focused mainly on abnormalities in vital signs in patients admitted to the inpatient ward. The objective of this study was to determine the patient and system factors that experienced clinicians think are associated with progression to critical illness in hospitalized children. METHODS: We conducted a modified Delphi study with 3 iterations, administered electronically...
October 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27649072/qsofa-sirs-and-early-warning-scores-for-detecting-clinical-deterioration-in-infected-patients-outside-the-icu
#9
Matthew M Churpek, Ashley Snyder, Xuan Han, Sarah Sokol, Natasha Pettit, Michael D Howell, Dana P Edelson
RATIONALE: The 2016 definitions of sepsis included the quick Sepsis-related Organ Failure Assessment (qSOFA) score to identify high-risk patients outside the intensive care unit (ICU). OBJECTIVE: We sought to compare qSOFA to other commonly used early warning scores. METHODS: All admitted patients first meeting criteria for suspicion of infection in the emergency department (ED) or hospital wards from November 2008 until January 2016 were included...
September 20, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27626832/clinical-study-of-a-new-modified-early-warning-system-scoring-system-for-rapidly-evaluating-shock-in-adults
#10
Qin Qin, Yiqin Xia, Yu Cao
OBJECTIVE: Shock, the most common severe emergency syndrome, has a complicated etiopathogenesis, is difficult to identify, progresses quickly, and is dangerous. Early identification and intervention play determining roles in the final outcomes of shock patients, but no specific scoring system for shock has been established to date. METHODS: We collected 292 shock patients and analyzed the correlation between 28-day prognosis and the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II), Modified Early Warning System (MEWS), and Sequential Organ Failure Assessment scoring systems...
September 2, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27489621/high-performance-detection-and-early-prediction-of-septic-shock-for-alcohol-use-disorder-patients
#11
Jacob Calvert, Thomas Desautels, Uli Chettipally, Christopher Barton, Jana Hoffman, Melissa Jay, Qingqing Mao, Hamid Mohamadlou, Ritankar Das
BACKGROUND: The presence of Alcohol Use Disorder (AUD) complicates the medical conditions of patients and increases the difficulty of detecting and predicting the onset of septic shock for patients in the ICU. METHODS: We have developed a high-performance sepsis prediction algorithm, InSight, which outperforms existing methods for AUD patient populations. InSight analyses a combination of singlets, doublets, and triplets of clinical measurements over time to generate a septic shock risk score...
June 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/27418264/remote-triage-support-algorithm-based-on-fuzzy-logic
#12
Jugoslav Achkoski, S Koceski, D Bogatinov, B Temelkovski, G Stevanovski, I Kocev
OBJECTIVES: This paper presents a remote triage support algorithm as a part of a complex military telemedicine system which provides continuous monitoring of soldiers' vital sign data gathered on-site using unobtrusive set of sensors. METHODS: The proposed fuzzy logic-based algorithm takes physiological data and classifies the casualties according to their health risk level, calculated following the Modified Early Warning Score (MEWS) methodology. RESULTS: To verify the algorithm, eight different evaluation scenarios using random vital sign data have been created...
July 14, 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27391204/validation-of-the-intensive-care-unit-early-warning-dashboard-quality-improvement-utilizing-a-retrospective-case-control-evaluation
#13
Michael J Kavanaugh, Joanne D So, Peter J Park, Konrad L Davis
INTRODUCTION: Risk stratification with the Modified Early Warning System (MEWS) or electronic cardiac arrest trigger (eCART) has been utilized with ward patients to preemptively identify high-risk patients who might benefit from enhanced monitoring, including early intensive care unit (ICU) transfer. In-hospital mortality from cardiac arrest is ∼80%, making preventative interventions an important focus area. ICUs have lower patient to nurse ratios than wards, resulting in less emphasis on the development of ICU early warning systems...
July 8, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27160454/the-role-of-planned-and-on-demand-relaparotomy-in-the-developing-world
#14
M F Scriba, G L Laing, J L Bruce, B Sartorius, D L Clarke
INTRODUCTION/BACKGROUND: This study compares planned repeat laparotomy (PR) with on-demand repeat laparotomy (OD) in a developing world setting. MATERIALS AND METHODS: This study was conducted over a 30-month study period (December 2012-May 2015) at Greys Hospital, Pietermaritzburg, South Africa. All trauma and general surgery adult patients requiring a single relaparotomy were included in this study. Prospectively gathered data entered into an established electronic registry were retrospectively analysed...
July 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27124174/emergency-department-modified-early-warning-score-association-with-admission-admission-disposition-mortality-and-length-of-stay
#15
Juan J Delgado-Hurtado, Andrea Berger, Amit B Bansal
BACKGROUND: Geisinger Health System implemented the Modified Early Warning Score (MEWS) in 2011 and is fully integrated to the Electronic Medical Record (EMR). Our objective was to assess whether the emergency department (ED) MEWS (auto-calculated by EMR) is associated with admission to the hospital, admission disposition, inpatient mortality, and length of stay (LOS) 4 years after its implementation. METHODS: A random sample of 3,000 patients' first encounter in the ED was extracted in the study period (between January 1, 2014 and May 31, 2015)...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27031791/obstetric-early-warning-systems-to-prevent-bad-outcome
#16
Audrey Catherine Quinn, Tim Meek, Carl Waldmann
PURPOSE OF REVIEW: Early warning scores, early warning systems and rapid response systems, were established in 1999. In the UK, a National Early Warning Score was launched in 2013 and is now used throughout the National Health Service. In 2007, a firm recommendation was made by the maternal confidential death enquiry that maternity units should incorporate a modified early obstetric warning score chart into clinical practice. Although there was enthusiastic uptake of this recommendation, local recording systems vary throughout the country and there is now a need to revisit revise and standardize an obstetric early warning system (ObsEWS)...
June 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26865981/use-of-a-modified-early-warning-score-system-to-reduce-the-rate-of-in-hospital-cardiac-arrest
#17
Isao Nishijima, Shouhei Oyadomari, Shuuto Maedomari, Risa Toma, Chisato Igei, Shinya Kobata, Jyun Koyama, Ryuichiro Tomori, Natsuki Kawamitsu, Yoshiki Yamamoto, Masafumi Tsuchida, Yoshihiro Tokeshi, Ryo Ikemura, Kazufumi Miyagi, Koichi Okiyama, Kiyoshi Iha
BACKGROUND: Physiological abnormalities are often observed in patients prior to cardiac arrest. A modified early warning score (MEWS) system was introduced, which aims to detect early abnormalities by grading vital signs, and the present study investigated its usefulness. METHODS: Based on previous reports, the Chubu Tokushukai Hospital-customized MEWS was developed in Okinawa, Japan. The MEWS was calculated among all inpatients, and the rates of in-hospital cardiac arrests (IHCAs) were compared according to the score...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/26856510/mandatory-early-warning-scoring-implementation-evaluated-with-a-mixed-methods-approach
#18
Gitte Bunkenborg, Ingrid Poulsen, Karin Samuelson, Steen Ladelund, Jonas Åkeson
AIM: The aim of this study was to evaluate adherence to an intervention optimizing in-hospital monitoring practice, by introducing early warning scoring (EWS) of vital parameters. BACKGROUND: Interventions comprising EWS systems reduce in-hospital mortality, but evaluation of adherence to such interventions is required to correctly interpret interventional outcome. METHOD: Adherence was evaluated with a mixed-methods approach. Quantitative data, obtained pre-interventionally (2009) and postinterventionally (2010 and 2011), were used to calculate and compare time intervals between scorings of vital parameters...
February 2016: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/26780181/modified-early-warning-scoring-mews-evaluating-the-evidence-for-tool-inclusion-of-sepsis-screening-criteria-and-impact-on-mortality-and-failure-to-rescue
#19
REVIEW
Jamie K Roney, Barbara Erin Whitley, Jessica C Maples, Lexie Scarborough Futrell, Kimberley A Stunkard, JoAnn D Long
AIMS AND OBJECTIVES: To evaluate current research evidence reporting outcomes from modified early warning scoring system tools utilisation to prevent failure to rescue in hospitalised adult medical-surgical/telemetry patients. BACKGROUND: Early sepsis detection exhibits clinical significance to practitioners and patients. Thorough and timely clinical observations, along with a willingness of nurses to call for help, are pivotal to survival of hospitalised patients...
December 2015: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/26761010/an-energy-efficient-skyline-query-for-massively-multidimensional-sensing-data
#20
Yan Wang, Wei Wei, Qingxu Deng, Wei Liu, Houbing Song
Cyber physical systems (CPS) sense the environment based on wireless sensor networks. The sensing data of such systems present the characteristics of massiveness and multi-dimensionality. As one of the major monitoring methods used in in safe production monitoring and disaster early-warning applications, skyline query algorithms are extensively adopted for multiple-objective decision analysis of these sensing data. With the expansion of network sizes, the amount of sensing data increases sharply. Then, how to improve the query efficiency of skyline query algorithms and reduce the transmission energy consumption become pressing and difficult to accomplish issues...
2016: Sensors
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