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On the Response to Acutely Deteriorating Patients

  • S. Mukherjee
  • S. J. Brett

Abstract

An aging population, increasingly complex surgical procedures and yet shorter inpatient stays has led to much a greater proportion of significantly ill patients within the in-patient population [1]. Such patients may benefit from input from critical care, hence the need for expansion of critical care beyond the traditional physical boundaries of high dependency and intensive care units [1]. Thus, in the United Kingdom the levels of care are now defined as follows [1].

Keywords

Cardiac Arrest Critical Care Medical Emergency Team Trigger System Outreach Service 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 2.
    Knaus WA, Draper EA, Wagner DP, Zimmerman JS (1985) APACHE II: a severity of disease classification system. Crit Care Med 13: 818–829CrossRefPubMedGoogle Scholar
  2. 3.
    McQuillan P, Pilkington S, Alan A, et al (1998) Confidential inquiry into quality of care before admission to intensive care. BMJ 316: 1853–1858PubMedGoogle Scholar
  3. 4.
    Kause J, Smith G, Prytherch D, et al (2004) A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom—the ACADEMIA study. Resuscitation 62: 275–282CrossRefPubMedGoogle Scholar
  4. 5.
    Goldhill DR, White SA, Sumner A (1999) Physiological values and procedures in the 24 h before ICU admission from the ward Anaesthesia 54: 529–534CrossRefPubMedGoogle Scholar
  5. 6.
    Cullinane M, Findlay G, Hargraves C, Lucas S (2005) An acute problem? A report of the National Confidential Enquiry into Patient Outcome and Death (NCEPOD). Available at: www.ncepod.org.uk/2005report/index.html. Accessed Dec 2009Google Scholar
  6. 7.
    Devita MA, Bellomo R, Hillman K, et al (2006) Findings of the first consensus conference on medical emergency teams. Crit Care Med 34: 2463–2478CrossRefPubMedGoogle Scholar
  7. 8.
    Goldhill DR, Worthington L, Mulcahy A, et al (1999) The patient-at-risk team: Identifying and managing seriously ill ward patients. Anaesthesia 54: 853–860CrossRefPubMedGoogle Scholar
  8. 9.
    Goldhill DR, Sumner A (1998) Outcome of intensive care patients in a group of British intensive care units. Crit Care Med 26: 1337–1345CrossRefPubMedGoogle Scholar
  9. 10.
    Goldhill DR, McNarry AF (2004) Physiological abnormalities in early warning scores are related to mortality in adult inpatients. Br J Anaesth 92: 882–884CrossRefPubMedGoogle Scholar
  10. 11.
    Stenhouse C, Coates S, Tivey M, et al (2000) Prospective evaluation of a modified Early Warning Score to aid detection of patients developing critical illness on a surgical ward. Br J Anaesth 84: 663P (abst)Google Scholar
  11. 12.
    Subbe CP, Hibbs R, Gemmel L, et al (2002) ASSIST: a screening tool for critically ill patients on general medical wards. Intensive Care Med 28: S21 (abst)Google Scholar
  12. 13.
    Rowan K (2004) Evaluation of Outreach Services in Critical Care. National Institute for Research Service Delivery and Organisation Programme. Available at: http://www. sdo.nihr.ac.uk/files/project/74-final-report.pdf. Accessed Dec 2009Google Scholar
  13. 14.
    Lee A, Bishop G, Hillman KM, et al (1995) The medical emergency team. Anaesth Intensive Care 23: 183–186PubMedGoogle Scholar
  14. 15.
    Berwick DM, Calkins DR, McCannon CJ, et al (2006) The 100,000 lives campaign: setting a goal and a deadline for improving healthcare quality JAMA 295: 324–327CrossRefPubMedGoogle Scholar
  15. 16.
    Gao H, Harrison DA, Harvey S, et al (2007) Systematic review and evaluation of physiological track and trigger warning system for identifying at-risk patient on the ward. Intensive Care Med 33: 667–679CrossRefPubMedGoogle Scholar
  16. 17.
    Hillman K, Chen J, Cretikos M, et al (2005) Introduction of Medical Emergency Team (MET) system: a cluster-randomised controlled trial. Lancet 365: 2091–2097CrossRefPubMedGoogle Scholar
  17. 18.
    Priestley G, Watson W, Pashidian A, et al (2004) Introducing Critical care Outreach: a wardrandomised trial of phased introduction in a general hospital. Intensive Care Med 30: 1398–1404CrossRefPubMedGoogle Scholar
  18. 19.
    Chan PS, Khalid A, Lance S, et al (2008) Hospital-wide code rates and mortality before and after implementation of a rapid response team. JAMA 300: 2506–2513CrossRefPubMedGoogle Scholar
  19. 20.
    Ball C, Kirkby M, Williams S (2003) Effect of critical care outreach team on patient survival to discharge from hospital and readmission to critical care: non-randomised population based study. BMJ 327: 1014–1017CrossRefPubMedGoogle Scholar
  20. 21.
    Gao H, Harrison DA, Harvey S, et al (2007) Systematic review and evaluation of physiological track and trigger warning system for identifying at-risk patient on the ward. Intensive Care Med 33: 667–679CrossRefPubMedGoogle Scholar
  21. 22.
    Esmonde L, McDonnell A, Ball C, et al (2006) Investigating the effectiveness of critical care outreach services: a systematic review, Intensive Care Med 32: 1713–1721CrossRefPubMedGoogle Scholar
  22. 23.
    McGaughey J, Alderdice F, Fowler R, Kapila A, Mayhew A, Moutray M (2009) Outreach and Early Warning System (EWS) for the prevention of intensive care admission and death of critically ill adult patients on general hospital wards, Cochrane Database Syst Rev: CD005529Google Scholar
  23. 24.
    Spearpoint KG, Gruber PC, Brett SJ (2009) Impact of the Immediate Life Support course on the incidence and outcome of in-hospital cardiac arrest calls: An observational study over 6 years. Resuscitation 80: 638–640CrossRefPubMedGoogle Scholar
  24. 25.
    Soar J, Perkins GD, Harris S, et al (2003) Immediate life support course. Resuscitation 57: 21–26CrossRefPubMedGoogle Scholar
  25. 26.
    Smith GB, Osgood VM, Crane S (2002) ALERTTM-a multi-professional training course in the care of acutely ill adult patient. Resuscitation 52: 281–286CrossRefPubMedGoogle Scholar
  26. 27.
    Jacques T, Harrison GA, McLaws ML, et al (2006) Combination of early signs of critical illness predicts in-hospital death-The SOCCER study. Resuscitation 71: 327–334CrossRefPubMedGoogle Scholar
  27. 28.
    Subbe CP, Kruger M, Gemmel L (2001) Validation of modified earlier warning score in medical admissions. Q J Med 94: 521–526Google Scholar
  28. 29.
    Sharpley JT, Holden JC (2004) Introducing an early warning scoring system in district general hospital. Nurs Crit Care 9: 98–103CrossRefPubMedGoogle Scholar
  29. 30.
    Hravnak M, Edwards L, Clontz A, et al (2008) Defining the incidence of cardiorespiratory instability in patients in step-down units using an electronic integrated monitoring system, Arch Intern Med 168: 1300–1308CrossRefPubMedGoogle Scholar
  30. 31.
    Tarassenko L, Hann A, Young D (2006). Integrated monitoring and analysis for early warning of patient deterioration. Br J Anaesth 97: 64–68CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media Inc. 2010

Authors and Affiliations

  • S. Mukherjee
    • 1
  • S. J. Brett
    • 1
  1. 1.Department of Anesthesia and Intensive CareHammersmith HospitalLondonUK

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