The nurse response to abnormal vital sign recording in the emergency department

2016 ◽  
Vol 26 (1-2) ◽  
pp. 148-156 ◽  
Author(s):  
Kimberly D Johnson ◽  
Lindsey Mueller ◽  
Chris Winkelman
Keyword(s):  
Emergency Department ◽  
Vital Sign ◽  
Abnormal Vital Sign

scholarly journals The association between abnormal vital sign groups and undesirable patient outcomes

2018 ◽  
Vol 25 (3) ◽  
pp. 137-145
Author(s):  
Marina Lee ◽  
David McD Taylor ◽  
Antony Ugoni
Keyword(s):  
Emergency Department ◽  
Confidence Interval ◽  
Patient Outcomes ◽  
Vital Sign ◽  
Odds Ratio ◽  
Medical Emergency Team ◽  
Vital Signs ◽  
Medical Emergency ◽  
Emergency Team ◽  
Abnormal Vital Sign

Introduction: To determine the association between both abnormal individual vital signs and abnormal vital sign groups in the emergency department, and undesirable patient outcomes: hospital admission, medical emergency team calls and death. Method: We undertook a prospective cohort study in a tertiary referral emergency department (February–May 2015). Vital signs were collected prospectively in the emergency department and undesirable outcomes from the medical records. The primary outcomes were undesirable outcomes for individual vital signs (multivariate logistic regression) and vital sign groups (univariate analyses). Results: Data from 1438 patients were analysed. Admission was associated with tachycardia, tachypnoea, fever, ≥1 abnormal vital sign on admission to the emergency department, ≥1 abnormal vital sign at any time in the emergency department, a persistently abnormal vital sign, and vital signs consistent with both sepsis (tachycardia/hypotension/abnormal temperature) and pneumonia (tachypnoea/fever) (p < 0.05). Medical emergency team calls were associated with tachycardia, tachypnoea, ≥1 abnormal vital sign on admission (odds ratio: 2.3, 95% confidence interval: 1.4–3.8), ≥2 abnormal vital signs at any time (odds ratio: 2.4, 95% confidence interval: 1.2–4.7), and a persistently abnormal vital sign (odds ratio: 2.7, 95% confidence interval: 1.6–4.6). Death was associated with Glasgow Coma Score ≤13 (odds ratio: 6.3, 95% confidence interval: 2.5–16.0), ≥1 abnormal vital sign on admission (odds ratio: 2.6, 95% confidence interval: 1.2–5.6), ≥2 abnormal vital signs at any time (odds ratio: 6.4, 95% confidence interval: 1.4–29.5), a persistently abnormal vital sign (odds ratio: 4.3, 95% confidence interval: 2.0–9.0), and vital signs consistent with pneumonia (odds ratio: 5.3, 95% confidence interval: 1.9–14.8). Conclusion: Abnormal vital sign groups are generally superior to individual vital signs in predicting undesirable outcomes. They could inform best practice management, emergency department disposition, and communication with the patient and family.

scholarly journals Emergency Department Abnormal Vital Sign “Triggers” Program Improves Time to Therapy

2011 ◽  
Vol 18 (5) ◽  
pp. 483-487 ◽  
Author(s):  
Daniel C. McGillicuddy ◽  
Francis J. O’Connell ◽  
Nathan I. Shapiro ◽  
Shelly A. Calder ◽  
Lawrence J. Mottley ◽  
...  
Keyword(s):  
Emergency Department ◽  
Vital Sign ◽  
Abnormal Vital Sign

scholarly journals Improving Recognition of Pediatric Severe Sepsis in the Emergency Department: Contributions of a Vital Sign–Based Electronic Alert and Bedside Clinician Identification

2017 ◽  
Vol 70 (6) ◽  
pp. 759-768.e2 ◽  
Author(s):  
Fran Balamuth ◽  
Elizabeth R. Alpern ◽  
Mary Kate Abbadessa ◽  
Katie Hayes ◽  
Aileen Schast ◽  
...  
Keyword(s):  
Emergency Department ◽  
Severe Sepsis ◽  
Vital Sign ◽  
Bedside Clinician

Variation in Orthostatic Vital Sign Testing in an Urban Academic Emergency Department

2013 ◽  
Vol 39 (6) ◽  
pp. 619-622 ◽  
Author(s):  
Michael D. Witting ◽  
Stacey Chaney Hydorn
Keyword(s):  
Emergency Department ◽  
Vital Sign

Analysis of Missed Sepsis Patients in a Pediatric Emergency Department With a Vital Sign-Based Electronic Sepsis Alert

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ellie Souganidis ◽  
Mary Kate Abbadessa ◽  
Brandon Ku ◽  
Christian Minich ◽  
Jane Lavelle ◽  
...  
Keyword(s):  
Emergency Department ◽  
Vital Sign ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department

scholarly journals Risk of bacteremia in patients presenting with shaking chills and vomiting - a prospective cohort study

2020 ◽  
Vol 148 ◽  
Author(s):  
M. Holmqvist ◽  
M. Inghammar ◽  
L. I. Påhlman ◽  
J. Boyd ◽  
P. Åkesson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Vital Sign ◽  
Bacterial Infections ◽  
Altered Mental Status ◽  
Negative Blood Culture ◽  
Multivariate Logistic Regression ◽  
Prospective Multicenter Study

Abstract Chills and vomiting have traditionally been associated with severe bacterial infections and bacteremia. However, few modern studies have in a prospective way evaluated the association of these signs with bacteremia, which is the aim of this prospective, multicenter study. Patients presenting to the emergency department with at least one affected vital sign (increased respiratory rate, increased heart rate, altered mental status, decreased blood pressure or decreased oxygen saturation) were included. A total of 479 patients were prospectively enrolled. Blood cultures were obtained from 197 patients. Of the 32 patients with a positive blood culture 11 patients (34%) had experienced shaking chills compared with 23 (14%) of the 165 patients with a negative blood culture, P = 0.009. A logistic regression was fitted to show the estimated odds ratio (OR) for a positive blood culture according to shaking chills. In a univariate model shaking chills had an OR of 3.23 (95% CI 1.35–7.52) and in a multivariate model the OR was 5.9 (95% CI 2.05–17.17) for those without prior antibiotics adjusted for age, sex, and prior antibiotics. The presence of vomiting was also addressed, but neither a univariate nor a multivariate logistic regression showed any association between vomiting and bacteremia. In conclusion, among patients at the emergency department with at least one affected vital sign, shaking chills but not vomiting were associated with bacteremia.

Are vital sign abnormalities associated with poor outcomes after emergency department discharge?

2019 ◽  
Vol 18 (2) ◽  
pp. 88-95
Author(s):  
Cindy Y Chang ◽  
◽  
Samer Abujaber ◽  
Maximilian J Pany ◽  
Ziad Obermeyer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Vital Sign ◽  
Conditional Logistic Regression ◽  
Early Death ◽  
Fold Increase ◽  
Additional Risk ◽  
Increased Risk ◽  
Matched Case ◽  
Poor Outcomes ◽  
Emergency Department Discharge

To examine association between vital sign abnormalities in the emergency department (ED) and early death after ED discharge, we performed a matched case-control study. Conditional logistic regression showed that presence of any vital sign abnormality at ED discharge was significantly associated with over three-fold increase in likelihood of death within 15 days of ED discharge (OR: 3.06, 95%CI: 2.81-4.48). Even small changes were associated with increased risk: every additional beat increase in heart rate conferred additional risk (OR: 1.04, 95%CI: 1.02-1.06), while every additional oxygen saturation percentage point was protective (0.89, 0.80-0.98). However, none of these vital sign abnormalities was a good predictor of early death; there was poor discrimination and substantial overlap in values between cases and controls.

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