scholarly journals Implementation of a maternal early warning system during early postpartum. A prospective observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252446
Author(s):  
Cristina Ibáñez-Lorente ◽  
Rubén Casans-Francés ◽  
Soledad Bellas-Cotán ◽  
Luis E. Muñoz-Alameda
Keyword(s):  
Blood Pressure ◽  
Multivariate Analysis ◽  
Early Warning ◽  
Early Warning System ◽  
Warning System ◽  
High Specificity ◽  
False Negatives ◽  
Critical Care Admission ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Objective To evaluate the implementation of a maternal early warning system (MEWS) for monitoring patients during the first two hours after delivery in a tertiary level hospital. Methods Implementation of the criteria between 15 March and 15 September 2018 was evaluated in 1166 patients. The parameters collected were systolic and diastolic blood pressure, heart rate, oxygen saturation, urine output, uterine involution, and bleeding. Out-of-range values of any of these parameters triggered a warning, and an obstetrician was called to examine the patient. The obstetrician then decided whether to call the anesthesiologist. We carried out a sensitivity-specificity study of triggers and a multivariate analysis of the factors involved in developing potentially fatal disorders (PFD), reintervention, critical care admission, and stay. Results The MEWS was triggered in 75 patients (6.43%). Leading trigger was altered systolic blood pressure in 32 patients (42.7%), and 11 patients had a PFD. Twenty-eight triggers were false-negatives. Sensitivity and specificity of the system was 0.28 (0.15, 0.45) and 0.94 (0.93, 0.96), respectively. The multivariate analysis showed a correlation between trigger activation and PFD. Conclusion Our MEWS presented low sensitivity and high specificity, with a significant number of false-negatives.

scholarly journals Experience in the implementation of the early warning sign system in obstetric patients (Maternal Early Warning Criteria, MEWC) during early postpartum. A prospective observational study.

2020 ◽  
Author(s):  
Cristina Ibanez ◽  
Ruben Casans-Frances ◽  
Soledad Bellas ◽  
Luis Enrique Munoz
Keyword(s):  
Blood Pressure ◽  
Multivariate Analysis ◽  
Early Warning ◽  
Tertiary Care ◽  
False Negative ◽  
Warning System ◽  
High Specificity ◽  
Warning Sign ◽  
Care Hospital ◽  
Low Sensitivity

Objective: To evaluate the implementation of an early warning system in obstetric patients (MEWC) during the first two hours after delivery in a single tertiary-care hospital. Methods: The MEWC system implementation was carried out from 15th March to 15th September 2018, over 1166 patients. The parameters collected were systolic and diastolic blood pressure, heart rate, oxygen saturation, diuresis, uterine involution, and bleeding. If a parameter was not within defined limits, an obstetrician first examined the patient, determining the need to call the anesthesiologist. We carried out a sensitivity-specificity study of the trigger and multivariate analysis of the factors involved in developing potentially fatal disorders (PFD), reintervention, critical care admission, and stay. Results: The protocol was triggered in 75 patients (6.43%). The leading cause of alarm activation was the altered systolic blood pressure (32 [42.7%] patients), and eleven developed PFD. Twenty-eight patients were false-negatives. Sensitivity and specificity of MEWC protocol were 0.28 (0.15, 0.45) and 0.94 (0.93, 0.96), respectively. Multivariate analysis showed a relationship between alarm activation and PFD. Conclusion: Our MEWC protocol presented low sensitivity and high specificity, having a significant number of false-negative patients.

scholarly journals Acute Pharmacological Effects and Oral Fluid Biomarkers of the Synthetic Cannabinoid UR-144 and THC in Recreational Users

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 257
Author(s):  
Nunzia La Maida ◽  
Esther Papaseit ◽  
Lucia Martínez ◽  
Clara Pérez-Mañá ◽  
Lourdes Poyatos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Observational Study ◽  
Early Warning ◽  
Early Warning System ◽  
Oral Fluid ◽  
Subjective Effects ◽  
Warning System ◽  
Pharmacological Effects ◽  
The Eu

Synthetic cannabinoids (SCs) are one of the most frequent classes of new psychoactive substances monitored by the EU Early Warning System and World Health Organization. UR-144 is a SC with a relative low affinity for the CB1 receptor with respect to that for the CB2 receptor. As with other cannabinoid receptor agonists, it has been monitored by the EU Early Warning System since 2012 for severe adverse effects on consumers. Since data for UR-144 human pharmacology are very limited, an observational study was carried out to evaluate its acute pharmacological effects following its administration using a cannabis joint as term of comparison. Disposition of UR-144 and delta-9-tetrahydrocannibinol (THC) was investigated in oral fluid. Sixteen volunteers smoked a joint prepared with tobacco and 1 or 1.5 mg dose of UR-144 (n = 8) or cannabis flowering tops containing 10 or 20 mg THC (n = 8). Physiological variables including systolic and diastolic blood pressure, heart rate and cutaneous temperature were measured. A set of Visual Analog Scales (VAS), the Addiction Research Centre Inventory (ARCI)-49-item short form version and the Evaluation of the Subjective Effects of Substances with Abuse Potential (VESSPA-SSE) were administered to evaluate subjective effects. Oral fluid was collected at baseline, 10, 20, 40 min and 1, 2, 3 and 4 h after smoking, for UR-144 or THC concentration monitoring. Results showed significant statistical increases in both systolic and diastolic blood pressure and heart rate after both UR-144 and cannabis smoking. Both substances produced an increase in VAS related to stimulant-like and high effects, but scores were significantly higher after cannabis administration. No hallucinogenic effects were observed. Maximal oral fluid UR-144 and THC concentrations appeared at 20 and 10 min after smoking, respectively. The presence of UR-144 in oral fluid constitutes a non-invasive biomarker of SC consumption. The results of this observational study provide valuable preliminary data of the pharmacological effects of UR-144, showing a similar profile of cardiovascular effects in comparison with THC but lower intensity of subjective effects. Our results have to be confirmed by research in a larger sample to extensively clarify pharmacological effects and the health risk profile of UR-144.

MODIFIKASI ASESMEN EARLY WARNING SYSTEM UPAYA PENINGKATAN PENERAPAN KESELAMATAN PASIEN

2020 ◽  
Vol 6 (2) ◽  
pp. 112
Author(s):  
Veronika Hutabarat ◽  
Enie Novieastari ◽  
Satinah Satinah
Keyword(s):  
Action Research ◽  
Early Warning ◽  
Early Warning System ◽  
Warning System ◽  
Planning Action

Salah satu faktor dalam meningkatkan penerapan keselamatan pasien adalah ketersediaan dan efektifitas prasarana dalam rumah sakit. Early warning system (EWS) merupakan prasarana dalam mendeteksi perubahan dini  kondisi pasien. Penatalaksanaan EWS masih kurang efektif karena parameter dan nilai rentang scorenya belum sesuai dengan kondisi pasien. Tujuan penulisan untuk mengidentifikasi efektifitas EWS dalam penerapan keselamatan pasien. Metode penulisan action research melalui proses diagnosa, planning action, intervensi, evaluasi dan  refleksi. Responden dalam penelitian ini adalah  perawat yang bertugas di area respirasi dan pasien dengan kasus kompleks respirasi di Rumah Sakit Pusat Rujukan Pernapasan Persahabatan Jakarta. Analisis masalah dilakukan dengan menggunakan diagram fishbone. Masalah yang muncul belum optimalnya implementasi early warning system dalam penerapan keselamatan pasien. Hasilnya 100% perawat mengatakan REWS membantu mendeteksi kondisi pasien, 97,4 % perawat mengatakan lebih efektif dan 92,3 % perawat mengatakan lebih efesien mendeteksi perubahan kondisi pasien. Modifikasi EWS menjadi REWS lebih efektif dan efesien dilakukan karena disesuaikan dengan jenis dan kekhususan Rumah Sakit dan berdampak terhadap kualitas asuhan keperawatan dalam menerapkan keselamatan pasien. Rekomendasi perlu dilakukan monitoring evaluasi terhadap implementasi t.erhadap implementasi REWS dan pengembangan aplikasi berbasis tehnologi

Development of a Pediatric Early Warning System Using Data-Driven Vital Signs

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 256A-256A
Author(s):  
Catherine Ross ◽  
Iliana Harrysson ◽  
Lynda Knight ◽  
Veena Goel ◽  
Sarah Poole ◽  
...  
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Vital Signs ◽  
Warning System ◽  
Data Driven ◽  
Using Data

KAJIAN KEKUATAN SINYAL RADIO (RSSI) XBEE DALAM RANGKA PEMASANGAN LANDSLIDE EARLY WARNING SYSTEM (LEWS) DI KABUPATEN GARUT, TASIKMALAYA DAN MAJALENGKA

2019 ◽  
Vol 3 (2) ◽  
pp. 88
Author(s):  
Riski Fitriani
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Warning System ◽  
Signal Strength ◽  
Received Signal Strength ◽  
Received Signal Strength Indicator ◽  
Landslide Early Warning ◽  
Point To Point

Salah satu inovasi untuk menanggulangi longsor adalah dengan melakukan pemasangan Landslide Early Warning System (LEWS). Media transmisi data dari LEWS yang dikembangkan menggunakan sinyal radio Xbee. Sehingga sebelum dilakukan pemasangan LEWS, perlu dilakukan kajian kekuatan sinyal tersebut di lokasi yang akan terpasang yaitu Garut, Tasikmalaya, dan Majalengka. Kajian dilakukan menggunakan 2 jenis Xbee yaitu Xbee Pro S2B 2,4 GHz dan Xbee Pro S5 868 MHz. Setelah dilakukan kajian, Xbee 2,4 GHz tidak dapat digunakan di lokasi pengujian Garut dan Majalengka karena jarak modul induk dan anak cukup jauh serta terlalu banyak obstacle. Topologi yang digunakan yaitu topologi pair/point to point, dengan mengukur nilai RSSI menggunakan software XCTU. Semakin kecil nilai Received Signal Strength Indicator (RSSI) dari nilai receive sensitivity Xbee maka kualitas sinyal semakin baik. Pengukuran dilakukan dengan meninggikan antena Xbee dengan beberapa variasi ketinggian untuk mendapatkan kualitas sinyal yang lebih baik. Hasilnya diperoleh beberapa rekomendasi tinggi minimal antena Xbee yang terpasang di tiap lokasi modul anak pada 3 kabupaten.

Summary of the stakeholders workshop to develop a National Volcano Early Warning System (NVEWS)

2006 ◽  
Author(s):  
Marianne Guffanti ◽  
William E. Scott ◽  
Carolyn L. Driedger ◽  
John W. Ewert
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Warning System
Sign in / Sign up

Export Citation Format

Share Document